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The GALE

ENCYCLOPEDIA of

ALTERNATIVE

MEDICINE

SECOND EDITION

The GALE

ENCYCLOPEDIA of

Alternative

Medicine

SECOND EDITION

VOLUME

A-C

JACQUELINE L. LONGE, PROJECT EDITOR

THOMSON

GALE

Detroit • New York • San Francisco • San Diego • New Haven, Conn. • Waterville, Maine • London • Munich

THOMSON

GALE

The Gale Encyclopedia of Alternative Medicine, Second Edition

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Jacqueline L. Longe

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LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

The Gale encyclopedia of alternative medicine / Jacqueline L. Longe,
project editor.-- 2nd ed.
p. ; cm.

Includes bibliographical references and index.

ISBN 0-7876-7424-9 (set hardcover : alk. paper) - ISBN 0-7876-7425-7 (v. 1 : alk.
paper) ~ ISBN 0-7876-7426-5 (v. 2 : alk. paper) - ISBN 0-7876-7427-3 (v. 3 : alk.
paper) -- ISBN 0-7876-7428-1 (v. 4 : alk. paper)

1. Alternative medicine— Encyclopedias.

[DNLM: 1. Complementary Therapies— Encyclopedias-English. 2. Internal
Medicine—

Encyclopedias-English. WB 13 G1507 2005] I. Title: Encyclopedia of
alternative medicine. II. Longe, Jacqueline L.

R733.G34 2005
61 5.5'03— dc22

2004022502

This title is also available as an e-book
ISBN 7876-9396-0 (set)

Contact your Gale sales representative for ordering information

ISBN 0-7876-7424-9(set)

0-7876-7425-7 (Vol. 1)

0-7876-7426-5 (Vol. 2)

0-7876-7427-3 (Vol. 3)

0-7876-7428-1 (Vol. 4)

Printed in the United States of America
1098765432 1

CONTENTS

List of Entries vii

About the Encyclopedia xvii

Advisory Board xix

Contributors xxi

Entries

Volume 1: A-C 1

Volume 2: D-K 523

Volume 3: L-R 1029

Volume 4: S-Z 1523

Organizations 2199

Glossary 2225

General Index 2293

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

LIST OF ENTRIES

Apis

Bates method

1 A

Apitherapy

Bayberry

Abscess

Appendicitis

Bedsores

Acidophilus

Applied kinesiology

Bedwetting

Acne

Apricot seed

Bee pollen

Aconite

Arginine

Behavioral optometry

Acupressure

Arnica

Behavioral therapy

Acupuncture

Aromatherapy

Belladonna

Ademetionine

Arrowroot

Beta-hydroxy

Adie’s pupil

Arsenicum album

Beta-methylbutyric acid

African pygeum

Art therapy

Beta carotene

Agastache

Ashwaganda

Betaine hydrochloride

Aging

Asthma

Bhakti yoga

AIDS

Astigmatism

Bilberry

Alcoholism

Aston-Patterning

Binge eating disorder

Alexander technique

Astragalus

Biofeedback

Alfalfa

Atherosclerosis

Bioflavonoids

Alisma

Athlete’s foot

Biota

Allergies

Atkins diet

Biotin

Allium cepa

Atractylodes (white)

Bipolar disorder

Aloe

Attention-deficit hyperactivity dis-

Bird flu

Alpha-hydroxy

order

Bites and stings

Alzheimer’s disease

Aucklandia

Bitter melon

Amino acids

Auditory integration training

Bitters

Andrographis

Aura therapy

Black cohosh

Androstenedione

Auriculotherapy

Black currant seed oil

Anemarrhena

Autism

Black haw

Anemia

Ayurvedic medicine

Black walnut

Angelica root

Black cumin seed extract

Angina

Bladder cancer

Anise

1 B

Bladder infection

Ankylosing spondylitis

Blessed thistle

Anorexia nervosa

Bad breath

Blisters

Anthroposophical medicine

Balm of Gilead

Blood poisoning

Antioxidants

Barberry

Blood clots

Anxiety

Barley grass

Bloodroot

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

VII

List of Entries

Blue cohosh
Body odor
Boils

Bone spurs

Bonemeal

Boneset

Borage oil

Boron

Boswellia

Botanical medicine

Breast cancer

Breastfeeding problems

Breath therapy

Breema

Brewer’s yeast

Bromelain

Bronchitis

Bruises

Bruxism

Bryonia

Buchu

Buckthorn

Bugleweed

Bulimia nervosa

Bunions

Burdock root

Burns

Bursitis

Butcher’s broom
Buteyko

Cadmium poisoning
Caffeine

Calcarea carbonica
Calcium
Calendula
Cancer

Cancer treatments, biological

Candidiasis

Canker sores

Cantharis

Carnitine

Carotenoids

Carpal tunnel syndrome

Cartilage supplements

Castor oil

Cat’s claw

Cataracts

Catnip

Cayce systems
Cayenne
Celiac disease
Cell therapy
Cell salt therapy
Cellulite

Cerebral vascular insufficiency

Cerebral palsy

Cervical dysplasia

Chakra balancing

Chamomile

Charcoal, activated

Chasteberry tree

Chelated minerals

Chelation therapy

Chemical poisoning

Cherry bark

Chickenpox

Chickweed

Chicory

Childbirth

Childhood nutrition

Chills

Chinese massage

Chinese system of food cures

Chinese thoroughwax

Chinese yam

Chinese foxglove root

Chiropractic

Chlamydia

Chlorella

Cholesterol

Chondroitin

Christian Science healing
Chromium

Chronic fatigue syndrome
Chrysanthemum flower
Chymotrypsin
Cicada

Cinnamon bark
Cirrhosis
Cnidium seeds
Codonopsis root

Coenzyme Q 1()

Coix

Cold sores

Coleus

Colic

Colloidal silver

Colonic irrigation

Color therapy

Colorectal cancer

Colostrum

Coltsfoot

Comfrey

Common cold

Conjunctivitis

Constipation

Contact dermatitis

Copper

Coptis

Cordyceps

Corns and calluses

Cornsilk

Cornus

Corydalis

Cotton root bark

Cough

Cradle cap

Cramp bark

Cranberry

Craniosacral therapy
Creatine
Crohn’s disease
Croup

Crystal healing
Cupping
Curanderismo
Cuscuta

Cuts and scratches
Cymatic therapy
Cyperus

Damiana
Dance therapy
Dandelion
Dandruff

VIII

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Deglycyrrhizanated licorice

Evening primrose oil

Gelsemium

Dementia

Evodia fruit

Genital herpes

Depression

Exercise

Genital warts

Dermatitis

Eyebright

Gentiana

Detoxification

Geriatric massage

Devil’s claw

Gerson therapy

DHEA

Ginger

Diabetes mellitus

Ginkgo biloba

Diamond diet

Facial massage

Ginseng, American

Diaper rash

Fasting

Ginseng, Korean

Diarrhea

Fatigue

Ginseng, Siberian

Diathermy

Feldenkrais

Glaucoma

Diets

Feng shui

Glucosamine

Digestive enzymes

Fennel

Glutamine

Diverticulitis

Fenugreek

Glutathione

Dizziness

Ferrum phosphoricum

Goldenrod

Dolomite

Fever

Goldenseal

Dong quai

Feverfew

Gonorrhea

Dry mouth

Fibrocystic breast disease

Gotu kola

Dyslexia

Fibromyalgia

Gout

Dysmenorrhea

Fish oil

Grains-of-paradise fruit

5-HTP

Grape skin

Flaxseed

Grape seed extract

Flower remedies

Grapefruit seed extract

Fo ti

Green tea

Ear infection

Folic acid

Guggul

Earache

Food poisoning

Guided imagery

Echinacea

Foxglove

Gulf War syndrome

Eczema

Fractures

Gum disease

Edema

French green clay

Gymnema

Elder

Fritillaria

Electroacupuncture

Frostbite and frostnip

Elimination diet

Fungal infections

Emphysema

Endometriosis

Flair loss

Energy medicine

Flangover

Environmental therapy

Flatha yoga

Enzyme therapy

Gallstones

Hawthorn

Ephedra

Gamma-linoleic acid

Hay fever

Epididymitis

Gangrene

Headache

Epilepsy

Ganoderma

Hearing loss

Epimedium

Gardenia

Heart disease

Essential fatty acids

Garlic

Heart attack

Essential oils

Gas

Heartburn

Essiac tea

Gastritis

Heavy metal poisoning

Eucalyptus

Gastrodia

Heel spurs

Eucommia bark

Gastroenteritis

Hellerwork

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

List of Entries

Hemorrhoids
Hepar sulphuris
Hepatitis

Herbalism, Western

Herbalism, traditional Chinese

Herniated disk

Hiatal hernia

Hibiscus

Hiccups

High sensitivity C reactive protein
test

High-fiber diet
Hives

Hodgkin’s disease
Holistic dentistry
Holistic medicine
Homeopathy

Homeopathy, acute prescribing
Homeopathy, constitutional pre-
scribing
Honeysuckle
Hops

Horehound
Horse chestnut
Horsetail
Hot flashes
Humor therapy
Huna

Hydrotherapy

Hypercortisolemia

Hyperopia

Hyperparathyroidism

Hypertension

Hyperthermia

Hyperthyroidism

Hypnotherapy

Hypoglycemia

Hypothyroidism

Hyssop

I I

Iceland moss
Ignatia

Immuno-augmentation therapy

Impetigo

Impotence

Indigestion

Infant massage

Infections

Infertility

Inflammatory bowel disease

Influenza

Ingrown nail

Insomnia

Insulin resistance

Iodine

Ipecac

Ipriflavone

Iridology

Iron

Irritable bowel syndrome

Ischemia

Itching

Jaundice
Jet lag
Jock itch
Jojoba oil
Journal therapy
Juice therapies
Juniper

Juvenile rheumatoid arthritis

Kali bichromicum
Kampo medicine
Kaposi’s sarcoma
Kava kava
Kegel exercises
Kelley-Gonzalez diet
Kelp

Kidney stones
Kidney infections
Kirlian photography
Knee pain
Kneipp wellness
Kola nut
Kombucha
Kudzu

I L

Labyrinth walking
Lachesis

Lacto-ovo vegetarianism

Laryngitis

Lavender

Lazy eye

Lead poisoning

Learning disorders

Lecithin

Ledum

Lemon balm

Lemongrass

Leukemia

Lice infestation

Licorice

Light therapy

Linoleic acid

Livingston- Wheeler therapy

Lobelia

Lomatium

Lomilomi

Lou Gehrig’s disease

Low back pain

Lung cancer

Lutein

Lycium fruit

Lycopene

Lycopodium

Lyme disease

Lymphatic drainage

Lysimachia

Lysine

Macrobiotic diet

Macular degeneration

Magnesium

Magnetic therapy

Magnolia

Maitake

Malaria

Malignant lymphoma
Manganese

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Marijuana

Marsh mallow

Martial arts

Massage therapy

McDougall diet

Measles

Meditation

Mediterranean diet

Medium-chain triglycerides

Melatonin

Memory loss

Meniere’s disease

Meningitis

Menopause

Menstruation

Mercurius vivus

Mesoglycan

Metabolic therapies

Methionine

Mexican yam

Migraine headache

Milk thistle

Mind/Body medicine

Mistletoe

Mononucleosis

Morning sickness

Motherwort

Motion sickness

Movement therapy

Moxibustion

MSM

Mugwort leaf
Mullein

Multiple chemical sensitivity
Multiple sclerosis
Mumps

Muscle spasms and cramps

Music therapy

Myopia

Myotherapy

Myrrh

Narcolepsy

Native American medicine

Natrum muriaticum
Natural hygiene diet
Natural hormone replacement ther-
apy

Naturopathic medicine

Nausea

Neck pain

Neem

Nettle

Neural therapy
Neuralgia

Neurolinguistic programming
Niacin

Night blindness
Noni

Nosebleeds
Notoginseng root
Nutmeg
Nutrition
Nux vomica

Oak

Obesity

Obsessive-compulsive disorder
Omega-3 fatty acids
Omega-6 fatty acids
Ophiopogon
Oregano essential oil
Ornish diet
Ortho-bionomy
Orthomolecular medicine
Osha

Osteoarthritis
Osteopathy
Osteoporosis
Ovarian cancer
Ovarian cysts
Oxygen/Ozone therapy

Pain

Paleolithic diet

Panchakarma
Pancreatitis
Panic disorder
Pantothenic acid
Parasitic infections
Parkinson’s disease
Parsley
Passionflower
Past-life therapy
Pau d'arco

Pelvic inflammatory disease

Pennyroyal

Peppermint

Peripheral neuropathy

Periwinkle

Pet therapy

Phlebitis

Phobias

Phosphorus

Pilates

Pinched nerve

Pine bark extract

Pinellia

Pityriasis rosea

Placebo effect

Plantain

Pleurisy

Pneumonia

Polarity therapy

Postpartum depression

Post-traumatic stress disorder

Potassium

Pranic healing

Prayer and spirituality

Pregnancy

Pregnancy massage

Premenstrual syndrome

Prickly heat

Prickly pear cactus

Pritikin diet

Probiotics

Prolotherapy

Prostate enlargement

Prostate cancer

Psoriasis

Psychoneuroimmunology
Psychophysiology
Psychosomatic medicine

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

List of Entries

Psychotherapy
Psyllium
Pulsatilla
Pulse diagnosis
Pyridoxine

Qigong
Quan yin

Rabies

Radiation injuries

Radiesthesia

Radionics

Rashes

Raspberry

Raynaud’s syndrome

Red cedar

Red clover

Red yeast rice extract

Reflexology

Reiki

Reishi mushroom

Relaxation

Rescue Remedy

Restless leg syndrome

Retinal detachment

Retinopathy

Rheumatic fever

Rheumatoid arthritis

Rhinitis

Rhubarb root

Rhus toxicodendron

Riboflavin

Rolfing

Rosacea

Rose hip

Rosemary

Rosen method

Royal jelly

Rubella

Rubenfeld synergy

Russian massage
Ruta

I s

Safflower flower

Saffron

Sage

Saliva sample testing

Sargassum seaweed

Sassafras

Saw palmetto

Scabies

Scallion

Scarlet fever

Schisandra

Schizophrenia

Sciatica

Scoliosis

Seasonal affective disorder

Selenium

Senior nutrition

Senna

Sensory deprivation

Sensory integration disorder

Sepia

Sesame oil

Sexual dysfunction

Shamanism

Sheep sorrel

Shiatsu

Shiitake mushroom
Shin splints
Shingles
Shintaido

Sick building syndrome
Sickle cell anemia
Silica

Sinus infection
Sjogren’s syndrome
Skin cancer
Skullcap
Sleep apnea
Sleep disorders
Slippery elm
Smoking

Sneezing
Snoring
Sodium
Somatics
Sore throat
Sound therapy
South Beach diet
Soy protein
Spearmint

Spinal manipulative therapy

Spirulina

Sports massage

Sprains and strains

Squawvine

St. John’s wort

Staphylococcal infections

Sties

Stomachaches
Stone massage
Strep throat
Stress
Stroke

Substance abuse and dependence

Sulfur

Suma

Sun’s soup

Sunburn

Swedish massage
Sweet clover
Swimmer’s ear
Syntonic optometry
Syphilis

Systemic lupus erythematoses

T’ai chi
Tangerine peel
Tea tree oil
Teenage nutrition
Teething problems
Temporomandibular joint syn-
drome
Tendinitis
Tennis elbow
Tetanus
Thai massage

XII

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Therapeutic touch

Uterine cancer

Wheezing

Thiamine

Uterine fibroids

White peony root

Thuja

Uva ursi

White willow

Thunder God vine

Whooping cough

Thyme

Wigmore diet

Tibetan medicine

Wild cherry

Tinnitus

Wild oat

Tonsillitis

Vaginitis

Wild yam

Toothache

Valerian

Wintergreen

Tourette syndrome

Vanadium

Witch hazel

Toxic shock syndrome

Varicose veins

Worms

Traditional African medicine

Veganism

Wormwood

Traditional Chinese medicine

Vegetarianism

Wounds

Trager psychophysical integration

Venom immunotherapy

Tremors

Vitamin A

Trepanation

Vitamin B complex

Trichomoniasis

Vitamin B ] ,

■ Y

Trigger point therapy

Vitamin C

Yarrow

Triphala

Vitamin D

Yeast infection

Tuberculosis

Vitamin E

Yellow dock

Turmeric

Vitamin K

Yerba santa

Vomiting

Yoga

Yohimbe

Yucca

—

Ulcers, digestive

Unani-tibbi

Warts

Urinary incontinence

Wasabi

Urine therapy

Wheat grass therapy

Zinc

Usnea

Wheat germ

Zone diet

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

XIII

List of Entries

PLEASE READ - IMPORTANT INFORMATION

The Gale Encyclopedia of Alternative Medicine is a
medical reference product designed to inform and edu-
cate readers about a wide variety of complementary ther-
apies and herbal remedies and treatments for prevalent
conditions and diseases. Thomson Gale believes the
product to be comprehensive, but not necessarily defini-
tive. It is intended to supplement, not replace, consulta-
tion with a physician or other healthcare practitioner.
While Thomson Gale has made substantial efforts to pro-
vide information that is accurate, comprehensive, and
up-to-date, Thomson Gale makes no representations or

warranties of any kind, including without limitation,
warranties of merchantability or fitness for a particular
purpose, nor does it guarantee the accuracy, comprehen-
siveness, or timeliness of the information contained in
this product. Readers should be aware that the universe
of complementary medical knowledge is constantly
growing and changing, and that differences of medical
opinion exist among authorities. They are also advised to
seek professional diagnosis and treatment for any med-
ical condition, and to discuss information obtained from
this book with their healthcare provider.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ABOUT THE ENCYCLOPEDIA

The Gale Encyclopedia of Alternative Medicine
(GEAM) is a one-stop source for alternative medical in-
formation that covers complementary therapies, herbs
and remedies, and common medical diseases and condi-
tions. It avoids medical jargon, making it easier for the
layperson to use. The Gale Encyclopedia of Alternative
Medicine presents authoritative, balanced information
and is more comprehensive than single-volume family
medical guides.

Scope

Over 800 full-length articles are included in The
Gale Encyclopedia of Alternative Medicine. Many
prominent figures are highlighted as sidebar biographies
that accompany the therapy entries. Articles follow a
standardized format that provides information at a
glance. Rubrics include:

Therapies

• Origins

• Benefits

• Description

• Preparations

• Precautions

• Side effects

• Research & general acceptance

• Resources

• Key terms

Herbs/remedies

• General use

• Preparations

• Precautions

• Side effects

• Interactions

• Resources

• Key terms

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Diseases/conditions

• Definition

• Description

• Causes & symptoms

• Diagnosis

• Treatment

• Allopathic treatment

• Expected results

• Prevention

• Resources

• Key terms

Inclusion criteria

A preliminary list of therapies, herbs, remedies, dis-
eases, and conditions was compiled from a wide variety
of sources, including professional medical guides and
textbooks, as well as consumer guides and encyclope-
dias. The advisory board, made up of three medical and
alternative healthcare experts, evaluated the topics and
made suggestions for inclusion. Final selection of topics
to include was made by the medical advisors in conjunc-
tion with Thomson Gale editors.

About the Contributors

The essays were compiled by experienced medical
writers, including alternative healthcare practitioners and
educators, pharmacists, nurses, and other complementary
healthcare professionals. GEAM medical advisors re-
viewed over 95% of the completed essays to insure that
they are appropriate, up-to-date, and medically accurate.

How to Use this Book

The Gale Encyclopedia of Alternative Medicine has
been designed with ready reference in mind:

• Straight alphabetical arrangement allows users
to locate information quickly.

XVII

About the Encyclopedia

• Bold faced terms function as print hyperlinks that
point the reader to related entries in the encyclo-
pedia.

• A list of key terms is provided where appropriate
to define unfamiliar words or concepts used with-
in the context of the essay. Additional terms may
be found in the glossary.

• Cross-references placed throughout the encyclo-
pedia direct readers to where information on sub-
jects without their own entries can be found. Syn-
onyms are also cross-referenced.

• A Resources section directs users to sources of
further complementary medical information.

• An appendix of alternative medical organizations
is arranged by type of therapy and includes valu-
able contact information.

• A comprehensive general index allows users to
easily target detailed aspects of any topic, includ-
ing Latin names.

Graphics

The Gale Encyclopedia of Alternative Medicine is
enhanced with over 450 images, including photos, ta-
bles, and customized line drawings. Each volume con-
tains a color insert of 64 important herbs, remedies, and
supplements.

XVIII

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ADVISORY BOARD

An advisory board made up of prominent individuals from complementary medical
communities provided invaluable assistance in the formulation of this encyclopedia.
They defined the scope of coverage and reviewed individual entries for accuracy and
accessibility. We would therefore like to express our appreciation to them:

Mirka Knaster, PhD

author, editor, consultant in Eastern and Western body-mind disciplines and spiritual traditions
Oakland, CA

Lisa Meserole, MS, ND
President, Botanical Medicine Academy
One Sky Medicine Clinic
Seattle, WA

Katherine E. Nelson, ND

Naturopathic Physician
Naples, FL

Jamison Starbuck, JD, ND

Naturopathic Family Physician

Former president, American Association of Naturopathic Physicians
Member, Homeopathic Academy of Naturopathic Physicians
Missoula, MT

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

XIX

CONTRIBUTORS

Margaret Alic, PhD

Medical Writer
Eastsound, WA

Greg Annussek
Medical Writer

American Society of Journalists and Authors
New York, NY

Barbara Boughton

Health and Medical Writer
El Cerrito, CA

Ruth Ann Prag Carter

Freelance Writer
Farmington Hills, MI

Linda Chrisman

Massage Therapist and Educator
Medical Writer
Oakland, CA

Gloria Cooksey, CNE
Medical Writer
Sacramento, CA

Amy Cooper, MA, MSI
Medical Writer
Vermillion, SD

Sharon Crawford

Writer, Editor, Researcher
American Medical Writers Association
Periodical Writers Association of Canada and the Editors’
Association of Canada
Toronto, ONT Canada

Sandra Bain Cushman

Massage Therapist

Alexander Technique Practitioner and Educator
Charlottesville, VA

Tish Davidson, MA

Medical Writer
Fremont, CA

Lori DeMilto, MJ

Medical Writer
Sicklerville, NJ

Doug Dupler, MA

Medical Writer
Boulder, CO

Paula Ford-Martin, PhD

Medical Writer
Warwick, RI

Rebecca J. Frey, PhD

Medical Writer
New Haven, CT

Lisa Frick

Medical Writer
Columbia, MO

Kathleen Goss
Medical Writer
Darwin, CA

Elliot Greene, MA

former president, American Massage Therapy Association
Massage Therapist
Silver Spring, MD

Peter Gregutt

Medical Writer
Asheville, NC

Clare Hanrahan

Medical Writer
Asheville, NC

David Helwig

Medical Writer
London, ONT Canada

Beth A. Kapes

Medical Writer, Editor
Bay Village, OH

Katherine Kim

Medical Writer
Oakland, CA

Erika Lenz

Medical Writer
Lafayette, CO

Lorraine Lica, PhD

Medical Writer
San Diego, CA

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

XXI

Contributors

Whitney Lowe, LMT

Orthopedic Massage Education & Research Institute
Massage Therapy Educator
Bend, OR

Mary McNulty

Freelance Writer
St.Charles, IL

Kathy Shepard Stolley, PhD

Medical Writer
Virginia Beach, VA

Judith Sims, MS

Science Writer
Logan, UT

Katherine E. Nelson, ND

Naturopathic physician
Naples, FL

Patricia Skinner

Medical Writer
Amman, Jordan

Teresa Odle

Medical Writer
Ute Park, NM

Genevieve Slomski, PhD

Medical Writer
New Britain, CT

Jodi Ohlsen Read

Medical Writer
Carver, MN

Jane E. Spear

Medical Writer
Canton, OH

Carole Osborne-Sheets

Massage Therapist and Educator
Medical Writer
Poway, CA

Lee Ann Paradise

Freelance Writer
Lubbock, TX

Liz Swain

Medical Writer
San Diego, CA

Judith Turner, DVM

Medical Writer
Sandy, UT

Patience Paradox

Medical Writer
Bainbridge Island, WA

Samuel Uretsky, PharmD

Medical Writer
Wantagh, NY

Belinda Rowland, PhD

Medical Writer
Voorheesville, NY

Ken R. Wells

Science Writer
Laguna Hills, CA

Joan M. Schonbeck, RN

Medical Writer
Marlborough, MA

Angela Woodward

Science Writer
Madison, WI

Gabriele Schubert, MS

Medical Writer
San Diego, CA

Kathleen Wright, RN

Medical Writer
Delrnar, DE

Kim Sharp, M Ln

Medical Writer
Houston, TX

Jennifer L. Wurges

Medical Writer
Rochester Hills, MI

XXII

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Abdominal pain see Stomachaches

Abscess

Definition

An abscess is a place of accumulation of the creamy
white, yellow, or greenish fluid, known as pus, surround-
ed by reddened tissue. It is the result of the body’s in-
flammatory response to a foreign body or a bacterial,
viral, parasitic, or fungal infection. An abscess usually
dries out and resolves when it is drained of pus. The
most common parts of the body affected by abscesses
are the face, armpits, arms and legs, rectum, sebaceous
glands (oil glands), and the breast during lactation.

Description

Most abscesses are septic, which means they are the
result of an infection. Abscesses occur when white blood
cells ( WBCs) gather in response to an infection. They pro-
duce oxidants (for example, superoxide radical) and en-
zymes to digest the invading bacteria, viruses, parasites, or
fungi. The infective agents are then broken down by the
WBCs into small pieces that can be transported through
the bloodstream and eliminated from the body. Unfortu-
nately, the enzymes may also digest part of the body’s tis-
sues along with the infective agents. The resulting liquid
of this digestion is pus, which contains the remains of the
infective agents, tissue, white blood cells, and enzymes.

A sterile abscess is one that is not produced by an
infection. It is caused by irritants, such as foreign bodies
or injected drugs, and medications that have not been to-
tally absorbed. Sterile abscesses quite often heal into
hardened scar tissue.

Common types of abscesses:

• Boils and carbuncles. Sebaceous glands and superficial
skin are the places usually infected.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Dental abscess. An abscess that develops along the root
of a tooth.

• Pilonidal abscess. People who have a birth defect in-
volving a tiny opening in the skin just above the anus
may have fecal bacteria enter this opening, causing an
infection and a subsequent abscess.

• Retropharyngeal, parapharyngeal, peritonsillar abscess.
As a result of throat infections like strep throat and
tonsillitis, bacteria invade the deeper tissues of the
throat and cause a parapharyngeal or peritonsillar ab-
scess. A retropharyngeal abscess is a result of some-
thing usually blood-borne, and not from a direct spread
of tonsillitis. These abscesses can compromise swal-
lowing and even breathing.

• Lung abscess. During or after pneumonia, an abscess
can develop as a complication.

• Liver abscess. Bacteria, parasites, or amoeba from the
intestines can spread through the blood to the liver and
cause abscesses.

• Psoas abscess. An abscess can develop in the psoas
muscles, when an infection spreads from the appendix,
the large intestine, or the fallopian tubes.

• Butin abscess. Any blood-borne feeding off bacteria
that stimulate pus production (pyogenic organisms).
Can cause abscesses in possibly many sites.

Causes & symptoms

Many different agents cause abscesses. The most
common are the pyogenic, or pus-forming bacteria, such
as Staphylococcus aureus, which is nearly always the
cause of abscesses directly under the skin. Abscesses are
usually caused by organisms that normally inhabit near-
by structures or that infect them. For example, abscesses
around the anus may be caused by any of the numerous
bacteria found within the large intestine. Brain abscesses
and liver abscesses are caused by the bacteria, amoeba,
and fungi that are able to travel there through circulation.

Abscess

An amoebic abscess caused by Entameoba histolytica.

(Phototake NYC. Reproduced by permission.)

Symptoms of an abscess are the general signs of in-
flammation. Symptoms that identify superficial abscess-
es include heat, redness, swelling, and pain over the af-
fected area. Abscesses in other places may produce only
generalized symptoms, such as fever and discomfort. A
sterile abscess may present as painful lump deep under
the site of an injection. A severe infection may bring on
fever, fatigue, weight loss, and chills. Recurrent abscess-
es may indicate undiscovered allergies or decreased im-
mune functioning.

Diagnosis

A general physical examination and a detailed pa-
tient history are used to diagnose an abscess. Recent or
chronic disease or dysfunction in an organ suggests it
may be the site of an abscess. Pain and tenderness on
physical examination are common findings. There may
also be a leakage of pus from a sinus tract connected to
an abscess deep in the body tissue.

Treatment

Bentonite clay packs with a small amount of gold-
enseal powder (Hydrastis canandensis ) can be placed on
the site of a superficial abscess and used to draw out the
infection. Tea tree oil ( Melaleuca spp.) and garlic (Alli-
um sativa) directly applied to abscesses may also help to
clear them.

Applications of a hot compress to the skin over the
abscess will hasten the draining or the reabsorption of
the abscess. Contrast hydrotherapy, using alternating
hot and cold compresses, can also be used. Additionally,
localized warm/hot soaks three to five times daily fre-
quently brings an abscess to heal.

Homeopathic remedies that can be taken to help di-
minish abscess formation include belladonna, silica,

Hepar sulphuris, and calendula. Also, acupuncture
may be recommended to help treat pain caused by an ab-
scess. In addition, vitamins A and C, beta-carotene, zinc,
liquid chlorophyll, and garlic are useful as supportive
daily nutrients to help clear up abscesses.

Allopathic treatment

Often, the pus of an abscess must be drained by a
physician. Ordinarily, the body will handle the remain-
ing infection. Sometimes antibiotics are prescribed. The
doctor may often put a piece of cloth or rubber, called a
drain, in the cavity of the abscess to prevent it from clos-
ing until all the pus has drained.

Expected results

Once the abscess is properly drained, it should clear
up in a few days. Any underlying diseases will determine
the overall outcome of the condition. Recurrent abscesses,
especially those on the skin, return due to either defec-
tive/altered immunity, or staph overgrowth, where there is
high bacterial colonization on the skin. The patient should
consult a physician for treatment with which to wash the
skin areas, and treatment to eradicate colonization.

If the abscess ruptures into neighboring areas or if
the infectious agent spills into the bloodstream, serious
consequences are likely. Abscesses in and around the
nasal sinuses, face, ears, and scalp may spread the infec-
tion into the brain. Abscesses in the abdominal cavity,
such as in the liver, may rupture into that cavity. Blood
poisoning, or septicemia, is an infection that has spilled
into the bloodstream and then spreads throughout the
body. These are emergency situations where the patient
needs to be seen by a physician as soon as possible.

It is important to take note that abscesses in the
hand may be more serious than they might appear. Due
to the intricate structure and the overriding importance
of the hand, any hand infection must be treated prompt-
ly and competently.

Prevention

Infections that are treated early with heat, if superfi-
cial, or antibiotics, if deeper, will often resolve without
the formation of an abscess. It is even better to avoid in-
fections altogether by promptly cleaning and irrigating
open injuries, particularly bites and puncture wounds.

Resources

BOOKS

Bennett, J. Claude and Fred Plum, ed. Cecil Textbook of Medi-
cine. Philadelphia: W. B. Saunders Co., 1996.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Bentonite clay — A green clay of aluminum silicate
containing magnesium and trace minerals. The
clay has the ability to attract and hold to its sur-
face agents of infection from a wound.

Enzyme — A protein that can increase the rate of
chemical reactions.

Sinus tract — A channel connecting a body part
with the skin outside.

Duke, James A., et at. The Green Pharmacy. Pennsylvania: Ro-
dale, 1997.

Isselbacher, Kurt, et at, ed. Harrison’s Principles of Internal
Medicine. New York: McGraw-Hill, 1997.

Tierney, Jr., Lawrence M., et al, ed. Current Medical Diagnosis
and Treatment. Connecticut: Appleton & Lange, 1996.

OTHER

AlternativeMedicine.com. <http://www.alternativemedicine.
com/> (December 28, 2000).

Patience Paradox

Absinthe see Wormwood

Aches and pains see Pain

Acidophilus

Description

Lactobacillus acidophilus , commonly referred to
simply as acidophilus, is a friendly inhabitant of the gas-
trointestinal (GI) tract. It, as well as some related strains
of bacteria, is known as a probiotic. Probiotic organisms
secrete enzymes that support healthy digestion. They
keep the flora of the intestines and vagina balanced, and
compete with some pathogenic organisms. When the pro-
biotic population of the body is severely decreased, as
can occur with treatment by many antibiotics, yeasts and
harmful bacteria may take over and cause illness. Normal
and healthy amounts of acidophilus can also be decreased
by chronic diarrhea, stress, infections, and poor diet.

The species of Lactobacilli that inhabit the GI tract
cause an increase of acidity. The bacteria do this by pro-
ducing lactic acid from milk sugar (lactose). The in-
creased acidity may promote the absorption of calcium,
as well as of some other minerals. Lowered pH also dis-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

courages the growth of many pathogenic species of bac-
teria and yeasts. The hydrogen peroxide produced by the
acidophilus also helps to suppress pathogens.

Acidophilus may function in the production of some
of the B vitamins, such as niacin, pyridoxine, biotin,
and folic acid.

General use

Yeast infections

Acidophilus may be used to reduce susceptibility to
vaginal yeast infections, which are quite common.
Symptoms including itching, burning, inflammation,
and discharge occur due to an overgrowth of the yeast
Candida albicans , which is part of the normal vaginal
flora. Some women are more prone to yeast infections
than others. Antibiotics destroy the normal probiotic
flora, and may lead to yeast infections. High sugar levels
are another predisposing factor. Diabetics, who tend to
have high blood sugar, and persons who consume a
processed diet that is high in sugar have more frequent
problems with yeast as well. The hormonal states created
by pregnancy or the use of oral contraceptives also con-
tribute to yeast infections. IUD users can also have an in-
creased rate of infection. In rare cases, Candida is sexu-
ally transmitted, and both partners may require treatment
in order to control repeated overgrowth. Anyone who has
AIDS or any other condition causing immunosuppres-
sion has increased susceptibility to Candida and other
types of infections too. Acidophilus is one of the organ-
isms that competes with Candida and decreases its popu-
lation. Many studies have shown that oral and topical use
(by douching) of acidophilus are effective to prevent and
treat this condition.

Systemic candidiasis, or yeast hypersensitivity syn-
drome, is a condition that is not recognized by many al-
lopaths. It is acknowledged by some practitioners of al-
ternative and complementary medicine as a problem
with broad-ranging consequences. This theory holds that
some people have an allergic reaction to the yeast and/or
its toxins, and that they can experience serious symp-
toms when the organism multiplies in the body to an ab-
normal degree. Fatigue, diarrhea, constipation, muscle
pain, thrush, itching, mood changes, endocrine dysfunc-
tion, headaches, and tingling or numbness of the extrem-
ities are some of the symptoms that are reportedly asso-
ciated with systemic candidiasis. A weak immune sys-
tem may be more prone to allowing yeast to multiply,
and large numbers of yeast can act to further suppress
the immune function. Acidophilus, in combination with
such nutritional supplements as essential fatty acids, is
often recommended for the prevention and treatment of
this syndrome.

Acidophilus

Gastrointestinal disorders

Irritable bowel syndrome (IBS) is a functional dis-
turbance of the lower intestine that can cause bloating,
cramping, abdominal pain, diarrhea, constipation, and
painful bowel movements. This condition is also known
as spastic colon. One small study of the use of aci-
dophilus to treat IBS showed more improvement in the
treated group than in those who took a placebo. This is
not conclusive evidence, but in view of the safety of the
treatment and the scarcity of effective alternatives, aci-
dophilus may be worth trying.

Traveler’s diarrhea is sometimes suffered by peo-
ple who consume contaminated food or water in other
countries. Some evidence shows that regular use of
acidophilus and other probiotics may prevent this con-
dition.

High cholesterol levels

Recent evidence suggests that consuming Lacto-
bacillus acidophilus LI can be effective in lowering
blood cholesterol. The February 1999 issue of the
Journal of the American College of Nutrition reports on
two studies done at the University of Kentucky. Sub-
jects who consumed the yogurt containing L. aci-
dophilus LI had cholesterol levels drop by 2.4% in one
study and 3.2% in the other. Although the percentages
are small, the effect on the risk of heart disease could
be significant.

Immune response

A study published in the December 1998 issue of
the Brazilian Journal of Medical and Biological Re-
search found that acidophilus induced a nonspecific
immune response in experimental mice. Acidophilus is
sometimes recommended as an immune booster for
people, although the effect has not yet been document-
ed in humans.

Other uses

Acidophilus may possibly be helpful in the treat-
ment of canker sores, fever blisters, hives, and adoles-
cent acne. Its use has also been suggested as a preventa-
tive for colon cancer.

Preparations

Acidophilus is taken by mouth. It is available as
powder, liquid, tablets, or capsules, and is also present
in some types of milk, kefir, yogurt, and some cheeses.
Frozen yogurt does not contain live probiotics. Check
product labels to see whether live organisms are present.
The bacteria are killed by pasteurization. Probiotic

KEY TERMS

Candidiasis — Any of a variety of infections caused
by fungi of the genus Candida.

Probiotic — Any strain of bacteria that lives in the
human gut and is considered a "friendly" bacteri-
um. Probiotics secrete enzymes that help to keep
the digestive system balanced, and compete with
some pathogenic organisms. Acidophilus is one of
the best-known probiotics.

Traveler's diarrhea — Diarrhea caused by ingesting
local bacteria to which one's digestive system has
not yet adapted.

products are most potent when kept refrigerated. The
potency of a given preparation is usually expressed as
the number of organisms per capsule. A usual dose of
acidophilus is 1-10 billion organisms, divided into three
doses per day.

Precautions

People who are lactose-intolerant may also not tol-
erate acidophilus.

Side effects

The initial use of acidophilus may cause an increase
in intestinal gas, which decreases with continued use of
the product.

Interactions

Taking acidophilus in conjunction with some antibi-
otics, including ampicillin (Amcill, Ampicin) and amox-
icillin (Amoxil, Novamoxin), can prevent the diarrhea
that is sometimes caused by their use.

Resources

BOOKS

Bratman, Steven, and David Kroll. Natural Health Bible.

Rocklin, CA: Prima Publishing, 1999.

Jellin, Jeff, Forrest Batz, and Kathy Hitchens. Pharmacist’ s let-
ter/Prescriber’s Letter Natural Medicines Comprehensive
Database. California: Therapeutic Research Faculty,
1999.

Lininger, Skye. The Natural Pharmacy. Rocklin, CA: Prima
Health, 1998.

Judith Turner

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Acne

Definition

Acne is a common inflammatory skin disease char-
acterized by pimples on the face, chest, and back. It oc-
curs when the pores of the skin become clogged with oil,
dead skin cells, and/or bacteria.

Description

Acne vulgaris, the medical term for common acne,
is the most common skin disease. It affects nearly 17
million people in the United States. While acne can arise
at any age, it usually begins at puberty and worsens dur-
ing adolescence. Nearly 85% of people develop acne
some time between the ages of 12 and 25 years old. Up
to 20% of women develop mild acne. It is also found in
some newborns.

The sebaceous glands lie just beneath the skin’s
surface. They produce sebum, an oily secretion that
helps to preserve the flexibility of the hair and moistur-
izes the skin. These glands and the hair follicles within
which they are found are called sebaceous follicles.
These follicles open onto the skin through pores that
allow the sebum to reach the hair shaft and the skin. In
certain situations, the glands excrete excess sebum and
it cannot be cleared from the pores efficiently. This
happens, for instance, at puberty when increased levels
of the androgen hormones cause overproduction of
sebum. In addition, cells lining the follicle are shed too
quickly and begin to clump together. The excess sebum
combines with the dead cells and forms a plug, or
comedo (also called comedones), that blocks the pore,
which is not usually seen. When the follicle begins to
bulge and show up as a small whitish bump mostly
under the skin, it is called a whitehead. If the comedo
opens up, the top surface of the plug darkens, and it is
referred to as a blackhead.

Infection results when a plugged follicle is invaded
by Propionibacterium acnes, a bacteria that normally
lives on the skin, and possibly other microorganisms.
The bacteria produce chemicals and enzymes that bring
on inflammation. Pimples are the result of infected
blackheads or whiteheads that rupture, releasing sebum,
bacteria, dead skin, and white blood cells onto the sur-
rounding tissues. Inflamed pimples near the skin’s sur-
face are called papules; they are red and raised, and may
be quite tender to the touch. The papules may become
filled with pus, and are then called pustules. If the folli-
cle continues to enlarge rather than rupture, it forms a
closed sac, called a cyst, which can be felt as a lump
under the skin. Large hard swellings deep within the skin

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Acne vulgaris affecting a woman’s face. Acne is the general
name given to a skin disorder in which the sebaceous
glands become inflamed. (Photograph by Biophoto Associ-
ates, Photo Researchers, Inc. Reproduced by permission.)

are called nodules. Both nodules and cysts may cause
pain and scarring.

Causes & symptoms

The exact cause of acne is mostly unknown. Some-
times when acne in women is due to excess male hor-
mone production, it is diagnosed by an onset of the con-
dition in adulthood; excessive growth of hair, especially
in places not usual on a female, called hirsuitism; irregu-
lar menstrual cycles; and premenstrual flare-ups of acne.
A 2001 study demonstrated that menstrual cycle does af-
fect acne. Surprisingly, the study revealed that 53% of
women over age 33 experienced a higher premenstrual
acne rate than women under age 20.

Many alternative practitioners assert that acne is
often related to a condition of toxicity in the intestines or
liver. This may be due to the presence of bacteria such as
Clostridia spp. and Yersinia enterocolitica, a low-fiber

Acne

diet; a lack of friendly gut flora such as Lactobacillus
spp.; an intestinal overgrowth of Candida albicans; and
food allergies.

The interaction between the body’s hormones, skin
protein, skin secretions, and bacteria determines the
course of acne. Several other factors have also been
shown to affect the condition:

• Age. Teenagers are more likely than anyone to develop
acne.

• Gender. Boys have more severe acne and develop it
more often than girls.

• Disease. Hormonal disorders can complicate acne in
girls.

• Heredity. Individuals with a family history of acne have
greater susceptibility to the condition.

• Hormonal changes. Acne can flare up before menstru-
ation, during pregnancy, and menopause.

• Diet. Although they are not the primary cause of acne,
certain foods may bring on flare-ups or make the con-
dition worse.

• Drugs. Acne can be a side effect of antibiotics, oral
contraceptives, and anabolic steroids.

• Personal hygiene. Use of abrasive soaps, hard scrub-
bing of the face, or handling pimples will often make
them worse.

• Cosmetics. Oil-based makeup and hair sprays worsen
acne.

• Environment. Exposure to oils and greases, polluted
air, and sweating in hot weather can all aggravate acne.

• Stress. Emotional stress may contribute to acne.

• Friction. Continual pressure or rubbing on the skin by
such things as bicycle helmets, backpacks, or tight
clothing, as well as hard scrubbing of the skin, can
worsen acne.

The most common sites of acne are the face, chest,
shoulders, and back, since these are the parts of the body
where the most sebaceous follicles are found. In
teenagers, acne is often found on the forehead, nose, and
chin. As people get older, it tends to appear towards the
outer part of the face. Adult women may have acne on
their chins and around their mouths. The elderly often de-
velop whiteheads and blackheads on the upper cheeks and
skin around the eyes. Inflamed lesions may cause redness,
pain, tenderness, itching, or swelling in affected areas.

Diagnosis

Acne has a characteristic appearance and is, there-
fore, not difficult to diagnose. A complete medical histo-

ry should be taken, including questions about skin care,
diet, factors that improve or worsen the condition, med-
ication use, and prior treatment. Physical examination
includes the face, upper neck, chest, shoulders, back, and
other affected areas. Under good lighting, the doctor can
determine what types and how many blemishes are pre-
sent, whether they are inflamed, whether they are deep
or superficial, and whether there is scarring or skin dis-
coloration. Blood tests are done when the patient appears
to have hormonal or other medical problems. Stool tests
can be helpful in determining whether there is a bacterial
or yeast overgrowth contributing to the condition. Food
allergy testing should also be considered.

Treatment

Alternative treatments for acne focus on proper
cleansing to keep the skin oil-free; intermittent fasting;
eating a good diet; an elimination diet where the indi-
vidual avoids alcohol, dairy products, smoking,
caffeine, sugar, processed foods, and foods high in io-
dine, a mineral which appears to contribute to acne.

Supplementation with herbs that are blood cleansers
or blood purifiers is recommended. These herbs
strengthen the action of the liver and the kidneys, help-
ing with detoxification and excretion. Dandelion root
tincture (Taraxacum officinale) is recommended. Others
include burdock root ( Arctium lappa), also known as
gobo, and can be purchased fresh at health food grocers
or in Asian markets. It can be used either raw or cooked
in salads, stir-fries, or other vegetable dishes. Burdock
root tincture can also be used. Red clover ( Trifolium
pratense) makes a pleasant tea that can be consumed
throughout the day. Milk thistle seed (Silybum mari-
anum) can either be taken in tincture form or the seeds
can be ground up and eaten in combination with hot ce-
real, granola, or other foods.

Other herbs useful in the treatment of acne include
Echinacea spp. and goldenseal (Hydrastis canadensis).
Goldenseal is particularly helpful in clearing up underly-
ing conditions of intestinal toxicity. Herbal remedies
used in traditional Chinese medicine (TCM) for acne
include cnidium seed, ( Cnidium monnieri), and honey-
suckle flower ( Lonicera japonica). Supplementation nu-
trients, such as essential fatty acids (EFAs), vitamin B
complex, zinc, vitamin A or beta-carotene, and chromi-
um are also recommended.

Bowel toxicity may contribute to acne flare-ups, and
should be addressed. Lactobacillus acidophilus and Lac-
tobacillus bulgaricus should be taken in yogurt or in
capsules to maintain a healthy balance of intestinal flora.
Goldenseal can be used to kill toxic bacteria. Allergic
foods should be identified and removed from the diet.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Dietary fiber, such as oats and wheat bran, beans, fruits
and vegetables and their skins, and psyllium seed,
should be increased in the diet. The fiber will absorb tox-
ins and carry them through the colon to be excreted.

In addition, those with acne may want to participate
in movement therapy, such as yoga or t’ai chi, or begin
an exercise regimen. The person may also consider
stress reduction or meditation.

Allopathic treatment

Acne treatment consists of reducing sebum and ker-
atin production, encouraging the shedding of dead skin
cells to help unclog the pores, and killing or limiting
bacteria. Treatment choice depends upon whether the
acne is mild, moderate, or severe. Complicated cases are
referred to a dermatologist, or an endocrinologist, who
treats diseases of the glands and the hormones. Counsel-
ing may be necessary to clear up misconceptions about
the condition and to offer support regarding the negative
effect of acne on the physical appearance.

Topical drugs

Treatment for mild acne consists of reducing the
formation of new comedones with over-the-counter acne
medications containing benzoyl peroxide (e.g., Clearasil,
Fostex), salicylic acid (Stridex), sulfur (Therac lotion),
resorcinol (Acnomel cream). Treatment with stronger
medications requires a doctor’s supervision. Such med-
ications include comedolytics, which are agents that
loosen hard plugs and open pores. Adapalene (Differin),
the vitamin A acid tretinoin (Retin-A), and concentrated
versions of salicylic acid, resorcinol, and sulfur are in
this group. Topical antibiotics, such as erythromycin,
clindamycin (Cleocin-T), and meclocycline (Meclan),
may be added to the treatment regimen. Drugs that act as
both comedolytics and antibiotics, such as benzoyl per-
oxide, azelaic acid (Azelex), or benzoyl peroxide plus
erythromycin (Benzamycin), are also used.

After washing with a mild soap, the acne medica-
tions are applied alone or in combination, once or twice
a day over the entire affected area of skin. It may take
many months to years to control the condition with these
medications. Possible side effects include mild redness,
peeling, irritation, dryness, and an increased sensitivity
to sunlight that requires use of a sunscreen.

Oral drugs

When acne is severe and the lesions are deep, oral
antibiotics may be taken daily to reduce the spread of
bacteria. Tetracycline is the medication most often used.
Minocycline, however, may be more preferable because

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

it has fewer side effects. Erythromycin and doxycycline
are also used, and they also have side effects, including
dizziness, photosensitivity, gastrointestinal problems,
and darkening of the skin. Other possible side effects in-
clude allergic reactions, yeast infections, dizziness,
tooth discoloration, and folliculitis. It is necessary for
antibiotics to be used for up to three months to clear up
the condition.

Isotretinoin (Accutane) can be used in cases of very
severe acne, or if antibiotic therapy proves unsuccessful.
It may clear up resistant cysts and nodules in up to 90%
of people and prevent scarring. Some do require a sec-
ond course of treatment before this happens, however.
Although the medication can be quite helpful, women
who might become pregnant should use it with care.
Isotretinoin can cause birth defects up to a month after it
has stopped being used. Therefore, strict attention is paid
to pregnancy tests and contraceptive requirements for
women of child-bearing age who take this medication.

The course of treatment with isotretinoin lasts about
four to five months. If dosage is kept low, a longer
course of therapy is needed. Isotretinoin is a strong med-
ication. Side effects are very common, mostly dryness of
the eyes, genital mucosa, and lips. Other effects may in-
clude increases in cholesterol, tryglicerides, and abnor-
mal liver enzymes. Blood tests taken each month should
be monitored during the course of treatment to ensure
that the medication is not causing serious harm.

Anti-androgens, drugs that inhibit androgen produc-
tion, are used to treat women who are unresponsive to
other therapies. Oral contraceptives such as norgesti-
mate/ethinyl estradiol (Ortho-Tri-Cyclen) have been
shown to improve acne. In late 2001, a clinical trial
demonstrated that ultra low-dose birth control pills
(Alesse) prove as effective in treating acne as do pills
with higher doses of estrogen. Improvement may take up
to four months.

Other drugs, such as spironolactone and corticos-
teroids, may be used to reduce hormone activity in the
adrenal glands, reducing production of sebum. This is
the treatment of choice for an extremely severe, but rare
type of acne called acne fulminans, found mostly in ado-
lescent males. Acne conglobata, a more common form of
severe inflammation, is characterized by numerous,
deep, inflammatory nodules that heal with scarring. It is
treated with oral isotretinoin and corticosteroids.

Other types of treatment

Several surgical or medical treatments are available
to alleviate acne or the resulting scars:

• Comedone extraction. The comedo is removed from
the pore with a special tool.

Acne

Aconite

• Chemical peels. Glycolic acid is applied to peel off the
top layer of skin to reduce scarring.

• Dermabrasion. The affected skin is frozen with a chem-
ical spray, and removed by brushing or planing.

• Punch grafting. Deep scars are excised and the area re-
paired with small skin grafts.

• Intralesional injection. Corticosteroids are injected di-
rectly into inflamed pimples.

• Collagen injection. Shallow scars are elevated by colla-
gen protein injections.

• Laser treatments. Two types of laser treatments are proving
effective in treating acne scars. Laser-treated skin heals in
three to 10 days, depending on the treatment chosen.

Expected results

Most dermatologists now use a combination of ther-
apies to treat acne, depending on the individual. Results
of specific treatments will vary. Acne is not a serious
health threat. The most troubling aspects of this condi-
tion are the negative cosmetic effects and potential for
permanent scarring. Some people, especially teenagers,
become emotionally upset about their condition, and this
may contribute to social or emotional problems.

Acne is not considered curable, although it can be
controlled by proper treatment, with improvement possi-
bly taking many months. Acne tends to reappear when
treatment stops, but it often spontaneously improves over
time. Inflammatory acne may leave scars that require
further treatment.

Prevention

There are no sure ways to prevent acne, but the fol-
lowing steps may be taken to minimize flare-ups:

• Gentle washing of affected areas once or twice every day.

• Avoidance of abrasive cleansers.

• Limited use of makeup and moisturizers; with avoid-
ance of oil-based brands altogether.

• Oily hair should be shampooed often and worn up,
away from the face.

• A healthy, well-balanced diet should be eaten. Fresh
fruits and vegetables should be stressed, and foods that
seem to trigger flare-ups should be avoided.

• The face can be washed gently, twice daily with a soap
compounded of sulfur. Calendula officinalis, or other
substances that are useful against acne.

• Affected areas should not be handled excessively. Pim-
ples should not be squeezed or prodded, as this may con-
tribute to scarring, as well as spreading the acne lesions.

KEY TERMS

Androgens — Male sex hormones that are linked
with the development of acne.

Comedo — A hard plug composed of sebum and
dead skin cells.

Follicles — Structures where pimples form. They
are found within the skin and house the oil glands
and hair.

Isotretinoin — A drug that decreases sebum pro-
duction and dries up acne pimples.

Sebum — An oily skin moisturizer produced by se-
baceous glands.

• Emotional stress should be kept in check.

Resources

BOOKS

Murray, Michael, and Joseph Pizzorno. Encyclopedia of Natur-
al Medicine. 2nd ed. California: Prima Publishing, 1998.

Tierney Jr., Lawrence M., et at, eds. Current Medical Diagno-
sis and Treatment 2003 . 42nd ed. Connecticut: Appleton
& Lange, 2002.

PERIODICALS

“Combination Therapies Offer New Management Options for
Acne.” Medical Devices and Surgical Technology Week
(December 9, 2001): 13.

“Monthly Hormonal Changes in Menstrual Cyclel Affect
Flare-ups.” Health and Medicine Week (December 31,
2001): 4.

“Ultra Low-Dose Estrogen Birth Control Pill is Effective Treat-
ment.” Women's Health Weekly (October 4, 2001).

OTHER

Merck & Co., Inc. The Merck Manual Online. December 28,
2000 [cited October 2002]. <http://www.merck.com>.

Patience Paradox

Acne rosacea see Rosacea

Aconite

Description

Aconite is the common name for any of 100 or more
related species in the Aconitum genus. Two of the
species, Aconitum napellus and Aconitum carmichaeli

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

are used medicinally. The more popular remedy, Aconi-
tum napellus, is a plant that grows in mountainous re-
gions of Central Asia, Russia, Europe, and Great Britain.
This perennial plant from the Ranunculaceae family
grows to a height of 3 ft (1 m) and has dark green, glossy
leaves and dark blue flowers.

Other names for aconite are wolf’s bane, monks-
hood, blue rocket, and friar’s cap. Wolf’s bane is a direct
translation of the Greek word Lycotonum. The Greeks
left the plant as poisonous bait for wolves or anointed ar-
rows with the juice of the herb in order to kill wolves.
The plant was nicknamed monkshood and friar’s cap be-
cause of the shape of the flowers.

The plant in its fresh form is highly poisonous. The
poison comes from the toxic alkaloid aconitine. Aconi-
tine is found in the whole plant but is mainly concentrat-
ed in the root. Symptoms of poisoning include tingling,
numbness of the tongue and mouth, nausea and vomit-
ing, labored breathing, a weak and irregular pulse, and
cold, clammy skin. Even the smallest amounts of aconi-
tine inside the mouth cause burning, tingling, and numb-
ness. As little as 2 mg of aconitine can cause death in as
little as 4 hours, which may be one reason why aconite is
often chosen by people attempting suicide by poison.
The Australian government has declared all species of
aconite “unfit for human consumption.”

General use

Western herbology

Herbalists have used aconite as a medicine for hun-
dreds of years. However, in ancient times the herb was
known more for its power to kill rather than heal; it was
often used in ancient Rome to commit murders.

The herb acts as a diuretic (a substance that pro-
motes urination) and diaphoretic (a substance that causes
sweating). Tinctures are taken internally to slow fevers,
pneumonia, laryngitis, and acute tonsillitis. Liniments
or ointments made from the herb are applied externally
to relieve the pain of neuralgia and rheumatism.

Traditional Chinese medicine

Aconitum carmichaeli is used in traditional Chi-
nese medicine. It is called Fu Zi (sometimes Fu Tzu) in
Mandarin; in other parts of China and in Hong Kong it is
known as chuan won ton.. This herb is used to treat
rheumatism, bruises, arthritis, acute hypothermia, diar-
rhea, and impotence. The herb is very hot and has a
sweet, spicy taste.

The main function of Fu Zi is to warm the interior. It
also works to restore collapsed yang, warm Kidney fire,
warm the Kidney and Spleen, drive out the cold, warm

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

the meridians, and relieve pain. Fu Zi is also used by tra-
ditional Chinese herbalists in conditions marked by defi-
cient Kidney and Spleen yang or in conditions with early
morning diarrhea or lack of appetite.

Aconitum carmichaeli also contains the toxic alka-
loid aconitine. After cooking the herb, the alkaloid is
converted to aconine, which is not as toxic.

This herb is poisonous. When it is properly prepared
as recommended by a Chinese medicine practitioner,
there are rarely any adverse effects. Chinese pharmacies
do not sell raw, untreated aconite, as the plant should be
dried and then brewed for long periods of time. There
have been, however, cases of aconite poisoning reported
in Asian countries, including some that ended in the pa-
tient’s death from heart arrhythmias. It appears that most
of these cases are due either to the herbalist’s prescribing
a larger dose of aconite than is needed, or to the patient’s
attempting to prepare the remedy at home.

Homeopathy

Homeopaths prescribe aconite for conditions that
come on suddenly as a result of grief, fear, anger, shock,
or exposure to cold, dry wind. It is also recommended for
people troubled by suicidal thoughts. The remedy is short-
acting and is indicated at the onset of acute conditions
such as croup, colds, cough, bronchitis, eye and ear in-
fections, headaches, and rheumatism. This remedy is one
of the best for measles, arthritis, and pneumonia when all
of the symptoms are present. Aconite is also useful at the
beginning of a fever, in early stages of inflammation, and
following shock caused by an injury or surgery.

Preparations

Aconite is available as a homeopathic remedy or in
dried bulk form, as an ointment or liniment, and as a
tincture. Pharmacies, health food stores, and Chinese
herbal stores carry the various preparations. They are
also available as prescribed by a herbalist, homeopathic
doctor, or Chinese medicine practitioner.

The whole plant is used in Western herbal medicine.
The leaves and flowers are cut when the flowers are in
blossom in June. The roots are collected after the stem
has died off, usually in August. The root is dried before
use while the leaves, stems, and flowers are used fresh.

The homeopathic preparation of aconite is created in
the following manner. The whole plant — but not the
root — is collected when the flowers are in full bloom and
pounded to a pulp. The juice from the pulp is pressed
and mixed with alcohol. The mixture is then strained and
diluted. The final homeopathic remedy is created after
the diluted mixture is repeatedly succussed (pounded

Aconite

against a hard surface to break down and mix the sub-
stance). The remedy is available at health-food and drug
stores in various potencies in the form of tinctures,
tablets, and pellets.

In traditional Chinese medicine, the aconite root is
generally used in small amounts in combination with
other herbs.

Precautions

If symptoms do not improve after the recommended
time period, consult your homeopath or other healthcare
practitioner.

Do not exceed the recommended dosage.

Use Aconitum carmichaeli only under supervision
of a Chinese medical practitioner.

Aconite is poisonous and should not be consumed in
its raw state. Persons who gather wild plants to eat
should be very careful in identifying what they are gath-
ering; cases have been reported of aconite poisoning in
people who thought they were gathering “mountain
chicory.”

Women who are pregnant, trying to get pregnant, or
who are breast-feeding should not use Aconitum car-
michaeli.

Side effects

Symptoms of poisoning by the fresh aconite plant
include tingling, numbness of the tongue and mouth,
nausea, vomiting, labored breathing, a weak and irregu-
lar pulse, and cold, clammy skin. In cases of severe poi-
soning, aconite can produce extreme symptoms that in-
clude severe pain, convulsions, paralysis, confusion,
seizures, and heart failure. The only established treat-
ment for aconite poisoning is supportive; that is, there is
no antidote.

Most liniments or lotions made with aconite for ex-
ternal use contain a 1.3% concentration of the herb. Use
of these preparations must be limited to unbroken skin,
as aconite can be absorbed through the skin and cause
toxic symptoms. If a skin reaction occurs, use of the lini-
ment must be discontinued immediately.

Interactions

When taking any homeopathic remedy, do not use
peppermint products, coffee, or alcohol. These products
will make the remedy ineffective.

Aconitum carmichaeli should not be used in those
having a deficiency of yin, or coolness, or with signs of
heat such as fever, redness, and agitation.

KEY TERMS

Aconitine — A toxic alkaloid contained in aconite.
As little as 2 mg taken internally may be fatal.

Antidote — A medication or remedy given to coun-
teract the effects of a poison.

Diaphoretic — A substance that causes sweating.
Diuretic — A substance that promotes urination.
Succussion — A process integral to the creation of
a homeopathic remedy in which a solution is re-
peatedly struck against a firm surface. This is per-
formed to thoroughly mix the substance and mag-
nify its healing properties.

Toxicology — The branch of medical pharmacolo-
gy dealing with the detection, effects, and anti-
dotes of poisons.

Resources

BOOKS

Cummings, Stephen, M.D., and Dana Ullman. Everybody' s
Guide to Homeopathic Medicines. New York: Putnam,
1997.

Kent, James Tyler. Lectures on Materia Medica. Delhi, India:
B. Jain Publishers, 1996.

Reid, Daniel. Chinese Herbal Medicine. Boston, MA: Shamb-
hala, 1996.

PERIODICALS

Chan, T. Y. "Incidence of Herb-Induced Aconitine Poisoning in
Hong Kong: Impact of Publicity Measures to Promote
Awareness Among the Herbalists and the Public.” Drug
Safety 25 (2002): 823-828.

Elliott, S. P. “A Case of Fatal Poisoning with the Aconite Plant:
Quantitative Analysis in Biological Fluid.” Science and
Justice 42 (April-June 2002): 111-115.

Gaibazzi, N., G. P. Gelmini, G. Montresor, et al. “Case Study
of Accidental Aconite Poisoning.” [in Italian] Italian
Heart Journal 3 (August 2002): 874-877.

ORGANIZATIONS

American Academy of Clinical Toxicology. Ill East Park
Drive, P. O. Box 8820, Harrisburg, PA 17105. (717) 558-
7750. <http://www.clintox.org>.

National Center for Homeopathy. 801 N. Fairfax St., Suite 306,
Alexandria, VA 22314. (703) 548-7790.

Jennifer Wurges
Rebecca J. Frey, PhD

Acquired Immunodeficiency syndrome see

AIDS

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Acupressure

Definition

Acupressure is a form of touch therapy that utilizes
the principles of acupuncture and Chinese medicine. In
acupressure, the same points on the body are used as in
acupuncture, but are stimulated with finger pressure in-
stead of with the insertion of needles. Acupressure is
used to relieve a variety of symptoms and pain.

Origins

One of the oldest text of Chinese medicine is the
Huang Di, The Yellow Emperor’s Classic of Internal
Medicine, which may be at least 2,000 years old. Chinese
medicine has developed acupuncture, acupressure, herbal
remedies, diet, exercise, lifestyle changes, and other
remedies as part of its healing methods. Nearly all of the
forms of Oriental medicine that are used in the West
today, including acupuncture, acupressure, shiatsu, and
Chinese herbal medicine, have their roots in Chinese
medicine. One legend has it that acupuncture and acu-
pressure evolved as early Chinese healers studied the
puncture wounds of Chinese warriors, noting that certain
points on the body created interesting results when stimu-
lated. The oldest known text specifically on acupuncture
points, the Systematic Classic of Acupuncture , dates back
to 282 a.d. Acupressure is the non-invasive form of
acupuncture, as Chinese physicians determined that stim-
ulating points on the body with massage and pressure
could be effective for treating certain problems.

Outside of Asian- American communities, Chinese
medicine remained virtually unknown in the United
States until the 1970s, when Richard Nixon became the
first U.S. president to visit China. On Nixon’s trip, jour-
nalists were amazed to observe major operations being
performed on patients without the use of anesthetics. In-
stead, wide-awake patients were being operated on, with
only acupuncture needles inserted into them to control
pain. At that time, a famous columnist for the New York
Times, James Reston, had to undergo surgery and elected
to use acupuncture for anesthesia. Later, he wrote some
convincing stories on its effectiveness. Despite being ne-
glected by mainstream medicine and the American Med-
ical Association (AMA), acupuncture and Chinese medi-
cine became a central to alternative medicine practition-
ers in the United States. Today, there are millions of pa-
tients who attest to its effectiveness, and nearly 9,000
practitioners in all 50 states.

Acupressure is practiced as a treatment by Chinese
medicine practitioners and acupuncturists, as well as by
massage therapists. Most massage schools in American

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

include acupressure techniques as part of their bodywork
programs. Shiatsu massage is very closely related to acu-
pressure, working with the same points on the body and
the same general principles, although it was developed
over centuries in Japan rather than in China. Reflexology
is a form of bodywork based on acupressure concepts.
Jin Shin Do is a bodywork technique with an increasing
number of practitioners in America that combines acu-
pressure and shiatsu principles with qigong, Reichian
theory, and meditation.

Benefits

Acupressure massage performed by a therapist can
be very effective both as prevention and as a treatment
for many health conditions, including headaches, general
aches and pains, colds and flu, arthritis, allergies, asth-
ma, nervous tension, menstrual cramps, sinus problems,
sprains, tennis elbow, and toothaches, among others.
Unlike acupuncture which requires a visit to a profes-
sional, acupressure can be performed by a layperson.
Acupressure techniques are fairly easy to learn, and have
been used to provide quick, cost-free, and effective relief
from many symptoms. Acupressure points can also be
stimulated to increase energy and feelings of well-being,
reduce stress, stimulate the immune system, and allevi-
ate sexual dysfunction.

Description

Acupressure and Chinese medicine

Chinese medicine views the body as a small part of
the universe, subject to laws and principles of harmony
and balance. Chinese medicine does not make as sharp a
destinction as Western medicine does between mind and
body. The Chinese system believes that emotions and
mental states are every bit as influential on disease as
purely physical mechanisms, and considers factors like
work, environment, and relationships as fundamental to a
patient’s health. Chinese medicine also uses very different
symbols and ideas to discuss the body and health. While
Western medicine typically describes health as mainly
physical processes composed of chemical equations and
reactions, the Chinese use ideas like yin and yang, chi, and
the organ system to describe health and the body.

Everything in the universe has properties of yin and
yang. Yin is associated with cold, female, passive, down-
ward, inward, dark, wet. Yang can be described as hot,
male, active, upward, outward, light, dry, and so on.
Nothing is either completely yin or yang. These two
principles always interact and affect each other, although
the body and its organs can become imbalanced by hav-
ing either too much or too little of either.

Acupressure

Therapist working acupressure points on a woman’s shoulder. (Photo Researchers, Inc. Reproduced by permission.)

Chi (pronounced chee, also spelled qi or ki in Japan-
ese shiatsu) is the fundamental life energy. It is found in
food, air, water, and sunlight, and it travels through the
body in channels called meridians. There are 12 major
meridians in the body that transport chi, corresponding
to the 12 main organs categorized by Chinese medicine.

Disease is viewed as an imbalance of the organs and
chi in the body. Chinese medicine has developed intri-
cate systems of how organs are related to physical and
mental symptoms, and it has devised corresponding
treatments using the meridian and pressure point net-
works that are classified and numbered. The goal of acu-
pressure, and acupuncture, is to stimulate and unblock
the circulation of chi, by activating very specific points,
called pressure points or acupoints. Acupressure seeks to
stimulate the points on the chi meridians that pass close
to the skin, as these are easiest to unblock and manipu-
late with finger pressure.

Acupressure can be used as part of a Chinese physi-
cian’s prescription, as a session of massage therapy, or
as a self-treatment for common aches and illnesses. A
Chinese medicine practitioner examines a patient very
thoroughly, looking at physical, mental and emotional ac-

tivity, taking the pulse usually at the wrists, examining
the tongue and complexion, and observing the patient’s
demeanor and attitude, to get a complete diagnosis of
which organs and meridian points are out of balance.
When the imbalance is located, the physician will recom-
mend specific pressure points for acupuncture or acupres-
sure. If acupressure is recommended, the patient might
opt for a series of treatments from a massage therapist.

In massage therapy, acupressurists will evaluate a
patient’s symptoms and overall health, but a massage
therapist’s diagnostic training isn’t as extensive as a Chi-
nese physician’s. In a massage therapy treatment, a per-
son usually lies down on a table or mat, with thin cloth-
ing on. The acupressurist will gently feel and palpate the
abdomen and other parts of the body to determine energy
imbalances. Then, the therapist will work with different
meridians throughout the body, depending on which or-
gans are imbalanced in the abdomen. The therapist will
use different types of finger movements and pressure on
different acupoints, depending on whether the chi needs
to be increased or dispersed at different points. The ther-
apist observes and guides the energy flow through the
patient’s body throughout the session. Sometimes, spe-
cial herbs ( Artemesia vulgaris or moxa) may be placed

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

on a point to warm it, a process called moxibustion. A
session of acupressure is generally a very pleasant expe-
rience, and some people experience great benefit imme-
diately. For more chronic conditions, several sessions
may be necessary to relieve and improve conditions.

Acupressure massage usually costs from $30-70 per
hour session. A visit to a Chinese medicine physician or
acupuncturist can be more expensive, comparable to a
visit to an allopathic physician if the practitioner is an
MD. Insurance reimbursement varies widely, and con-
sumers should be aware if their policies cover alternative
treatment, acupuncture, or massage therapy.

Self-treatment

Acupressure is easy to learn, and there are many
good books that illustrate the position of acupoints and
meridians on the body. It is also very versatile, as it can
be done anywhere, and it’s a good form of treatment for
spouses and partners to give to each other and for parents
to perform on children for minor conditions.

While giving self-treatment or performing acupres-
sure on another, a mental attitude of calmness and atten-
tion is important, as one person’s energy can be used to
help another’s. Loose, thin clothing is recommended.
There are three general techniques for stimulating a pres-
sure point.

• Tonifying is meant to strengthen weak chi, and is done
by pressing the thumb or finger into an acupoint with a
firm, steady pressure, holding it for up to two minutes.

• Dispersing is meant to move stagnant or blocked chi,
and the finger or thumb is moved in a circular motion
or slightly in and out of the point for two minutes.

• Calming the chi in a pressure point utilizes the palm to
cover the point and gently stroke the area for about two
minutes.

There are many pressure points that are easily found
and memorized to treat common ailments from
headaches to colds.

• For headaches, toothaches, sinus problems, and pain in
the upper body, the “LI4” point is recommended. It is
located in the web between the thumb and index finger,
on the back of the hand. Using the thumb and index fin-
ger of the other hand, apply a pinching pressure until
the point is felt, and hold it for two minutes. Pregnant
women should never press this point.

• To calm the nerves and stimulate digestion, find the
“CV12” point that is four thumb widths above the
navel in the center of the abdomen. Calm the point with
the palm, using gentle stroking for several minutes.

Press on point governing vessel 24.5, the top of the bridge
of the nose, lightly for two minutes to relieve hay fever
symptoms. Press on lung 10, the center of the thumb pad,
for one minute to alleviate a sore throat. To ease heartburn,
apply pressure to stomach 36, four finger-widths below the
kneecap outside the shinbone. Use on both legs. (Illustra-
tion by Electronic Illustrators Group. The Gale Group.)

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Acupressure

Press on point pericardium 6 for one minute on each arm to
relieve general nausea. Press on stomach 3, at the bottom
of the cheekbones, to relieve a sinus headache. Squeezing
the webbed area between your forefinger and thumb, large
intestine 4, may also help relieve sinus pain. (Illustration by
Electronic Illustrators Group. The Gale Group.)

• To stimulate the immune system, find the “TH5” point
on the back of the forearm two thumb widths above the
wrist. Use a dispersing technique, or circular pressure
with the thumb or finger, for two minutes on each arm.

• For headaches, sinus congestion, and tension, locate
the “GB20” points at the base of the skull in the back
of the head, just behind the bones in back of the ears.
Disperse these points for two minutes with the fingers
or thumbs. Also find the “yintang” point, which is in
the middle of the forehead between the eyebrows. Dis-
perse it with gentle pressure for two minutes to clear
the mind and to relieve headaches.

Precautions

Acupressure is a safe technique, but it is not meant
to replace professional health care. A physician should
always be consulted when there are doubts about med-
ical conditions. If a condition is chronic, a professional
should be consulted; purely symptomatic treatment
can exacerbate chronic conditions. Acupressure should
not be applied to open wounds, or where there is
swelling and inflammation. Areas of scar tissue, blis-
ters, boils, rashes, or varicose veins should be avoid-
ed. Finally, certain acupressure points should not be
stimulated on people with high or low blood pressure
and on pregnant women.

Research & general acceptance

In general, Chinese medicine has been slow to gain
acceptance in the West, mainly because it rests on ideas
very foreign to the scientific model. For instance, West-
ern scientists have trouble with the idea of chi, the invisi-
ble energy of the body, and the idea that pressing on cer-
tain points can alleviate certain conditions seems some-
times too simple for scientists to believe.

Western scientists, in trying to account for the action
of acupressure, have theorized that chi is actually part of
the neuroendocrine system of the body. Celebrated or-
thopedic surgeon Robert O. Becker, who was twice nom-
inated for the Nobel Prize, wrote a book on the subject
called Cross Currents: The Promise of Electromedicine ;
The Perils of Electropollution. By using precise electri-
cal measuring devices, Becker and his colleagues
showed that the body has a complex web of electromag-
netic energy, and that traditional acupressure meridians
and points contained amounts of energy that non-acu-
pressure points did not.

The mechanisms of acupuncture and acupressure re-
main difficult to document in terms of the biochemical
processes involved; numerous testimonials are the pri-
mary evidence backing up the effectiveness of acupres-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

sure and acupuncture. However, a body of research is
growing that verifies the effectiveness in acupressure and
acupuncture techniques in treating many problems and
in controlling pain.

Training & certification

There are two routes to becoming trained in the skill
of acupressure. The first is training in traditional
acupuncture and Chinese medicine, which has many
schools and certifying bodies around the country. The
majority of acupressure practitioners are trained as certi-
fied massage therapists, either as acupressure or shiatsu
specialists.

The Acupressure Institute provides certification and
resources for acupressure practitioners. Address: 1533
Shattuck Ave., Berkeley, CA 94709, (800) 442-2232 or
(510) 845-1059, http://www.acupressure.com.

The American Oriental Bodywork Therapy Associa-
tion (AOBTA) certifies acupressure practitioners and has
over 1,400 members. It also provides a list of schools and
training programs. Address: 1010 Haddonfield-Berlin
Road, Suite 408, Voorhees, NJ 08043, phone (856) 782-
1616, email: office@aobta.org. ttp://222. aobta.org

The Jin Shin Do Foundation for Body/Mind Acu-
pressure is an international network of teachers and prac-
titioners. Address: RO. Box 416, Idyllwild, CA 92549.
phone: (909) 659-5707

The largest organization that certifies massage ther-
apists, with over 40,000 members worldwide, is the
American Massage Therapy Association. It also has a
member directory and lists of training programs. Web-
site: www.amtamassage.org.

Resources

BOOKS

Jarmey, Chris and John Tindall. Acupressure for Common Ail-
ments. London: Gaia, 1991.

Kakptchuk, Ted. The Web That Has No Weaver: Understanding
Chinese Medicine. New York: Congdon and Weed, 1983.
Warren, Frank Z., MD. Freedom From Pain Through Acupres-
sure. New York: Fell, 1976.

PERIODICALS

Massage Therapy Journal. 820 Davis Street, Suite 100,
Evanston, IL 60201-4444.

OTHER

American Association of Oriental Medicine, http://www.aaom.
org/ (December 28, 2000).

National Acupuncture and Oriental Medicine Alliance, http://
www.acuall.org/ (December 28, 2000).

Douglas Dupler

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Acupoint — A pressure point stimulated in acu-
pressure.

Chi — Basic life energy.

Meridian — A channel through which chi travels in
the body.

Moxibustion — An acupuncture technique that
burns the herb moxa or mugwort.

Shiatsu — Japanese form of acupressure massage.

Yin/yang — Universal characteristics used to de-
scribe aspects of the natural world.

Acupuncture

Definition

Acupuncture is one of the main forms of treatment in
traditional Chinese medicine. It involves the use of sharp,
thin needles that are inserted in the body at very specific
points. This process is believed to adjust and alter the
body’s energy flow into healthier patterns, and is used to
treat a wide variety of illnesses and health conditions.

Origins

The original text of Chinese medicine is the Nei
Ching, The Yellow Emperor’s Classic of Internal Medi-
cine , which is estimated to be at least 2,500 years old.
Thousands of books since then have been written on the
subject of Chinese healing, and its basic philosophies
spread long ago to other Asian civilizations. Nearly all of
the forms of Oriental medicine which are used in the
West today, including acupuncture, shiatsu, acupressure
massage, and macrobiotics, are part of or have their roots
in Chinese medicine. Legend has it that acupuncture de-
veloped when early Chinese physicians observed unpre-
dicted effects of puncture wounds in Chinese warriors.
The oldest known text on acupuncture, the Systematic
Classic of Acupuncture , dates back to 282 a.d. Although
acupuncture is its best known technique, Chinese medi-
cine traditionally utilizes herbal remedies, dietary thera-
py, lifestyle changes and other means to treat patients.

In the early 1900s, only a few Western physicians
who had visited China were fascinated by acupuncture,
but outside of Asian- American communities it remained
virtually unknown until the 1970s, when Richard Nixon
became the first U.S. president to visit China. On Nixon's
trip, journalists were amazed to observe major operations

Acupuncture

Woman undergoing facial acupuncture. (Photograph by Yoav Levy. Phototake NYC. Reproduced by permission.)

being performed on patients without the use of anesthet-
ics. Instead, wide-awake patients were being operated on
with only acupuncture needles inserted into them to con-
trol pain. During that time, a famous columnist for the
New York Times, James Reston, had to undergo surgery
and elected to use acupuncture instead of pain medication,
and he wrote some convincing stories on its effectiveness.

Today acupuncture is being practiced in all 50 states
by more than 9,000 practitioners, with about 4,000 MDs
including it in their practices. Acupuncture has shown no-
table success in treating many conditions, and more than

15 million Americans have used it as a therapy. Acupunc-
ture, however, remains largely unsupported by the med-
ical establishment. The American Medical Association
has been resistant to researching it, as it is based on con-
cepts very different from the Western scientific model.

Several forms of acupuncture are being used today
in America. Japanese acupuncture uses extremely thin
needles and does not incorporate herbal medicine in its
practice. Auricular acupuncture uses acupuncture points
only on the ear, which are believed to stimulate and bal-
ance internal organs. In France, where acupuncture is
very popular and more accepted by the medical estab-
lishment, neurologist Paul Nogier developed a system of

acupuncture based on neuroendocrine theory rather than
on traditional Chinese concepts, which is gaining some
use in America.

Benefits

The World Health Organization (WHO) recom-
mends acupuncture as an effective treatment for over
forty medical problems, including allergies, respiratory
conditions, gastrointestinal disorders, gynecological
problems, nervous conditions, and disorders of the eyes,
nose and throat, and childhood illnesses, among others.
Acupuncture has been used in the treatment of alco-
holism and substance abuse. In 2002, a center in Maine
received a unique grant to study acupuncture treatment
for substance abuse. Although recognizing that acupunc-
ture had been used before for helping those with abuse,
this study sought to show that ear acupuncture’s effects
on relaxation response helped those abusing drugs and
alcohol better deal with the anxiety and life circum-
stances thought to lead them to substance abuse.

Acupuncture is an effective and low-cost treatment
for headaches and chronic pain, associated with prob-
lems like back injuries and arthritis. It has also been used

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Traditional Chinese medicine teachings state that channels of energy flow throughout the body, and that disease is caused
by too much or to little flow of energy along these channels. Points along the channels, called meridians, are manipulated in
acupuncture. In the illustration, points are shown on the bladder (BL), conception vessel (CV), gall bladder (GB), governing
vessel (GV), heart (HE), kidney (Kl) large intestine (LI), liver (LV), lung (LU), pericardium (PE), small intestine (SI), spleen (SP),
stomach (ST), and triple warmer (TW) meridians. (Illustration by Electronic Illustrators Group. The Gale Group.)

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Acupuncture

to supplement invasive Western treatments like
chemotherapy and surgery. Acupuncture is generally
most effective when used as prevention or before a
health condition becomes acute, but it has been used to
help patients suffering from cancer and AIDS. In 2002,
the National Institutes of health announced that pain
from certain musculoskeletal conditions like fibromyal-
gia could be helped by acupuncture. Acupuncture is lim-
ited in treating conditions or traumas that require surgery
or emergency care (such as for broken bones).

Description

Basic ideas of Chinese medicine

Chinese medicine views the body as a small part of the
universe, and subject to universal laws and principles of har-
mony and balance. Chinese medicine does not draw a sharp
line, as Western medicine does, between mind and body.
The Chinese system believes that emotions and mental states
are every bit as influential on disease as purely physical
mechanisms, and considers factors like work, environment,
lifestyle, and relationships as fundamental to the overall pic-
ture of a patient’s health. Chinese medicine also uses very
different symbols and ideas to discuss the body and health.
While Western medicine typically describes health in terms
of measurable physical processes made up of chemical reac-
tions, the Chinese use ideas like yin and yang, chi, the organ
system, and the five elements to describe health and the
body. To understand the ideas behind acupuncture, it is
worthwhile to introduce some of these basic terms.

YIN AND YANG. According to Chinese philosophy,
the universe and the body can be described by two sepa-
rate but complementary principles, that of yin and yang.
For example, in temperature, yin is cold and yang is hot.
In gender, yin is female and yang is male. In activity, yin
is passive and yang is active. In light, yin is dark and
yang is bright; in direction yin is inward and downward
and yang is outward and up, and so on. Nothing is ever
completely yin or yang, but a combination of the two.
These two principles are always interacting, opposing,
and influencing each other. The goal of Chinese medi-
cine is not to eliminate either yin or yang, but to allow
the two to balance each other and exist harmoniously to-
gether. For instance, if a person suffers from symptoms
of high blood pressure, the Chinese system would say
that the heart organ might have too much yang, and
would recommend methods either to reduce the yang or
to increase the yin of the heart, depending on the other
symptoms and organs in the body. Thus, acupuncture
therapies seek to either increase or reduce yang, or in-
crease or reduce yin in particular regions of the body.

CHI. Another fundamental concept of Chinese medi-
cine is that of chi (pronounced chee. also spelled qi ). Chi

is the fundamental life energy of the universe. It is invisi-
ble and is found in the environment in the air, water, food
and sunlight. In the body, it is the invisible vital force that
creates and animates life. We are all born with inherited
amounts of chi, and we also get acquired chi from the
food we eat and the air we breathe. The level and quality
of a person’s chi also depends on the state of physical,
mental and emotional balance. Chi travels through the
body along channels called meridians.

THE ORGAN SYSTEM. In the Chinese system, there
are twelve main organs: the lung, large intestine, stom-
ach, spleen, heart, small intestine, urinary bladder, kid-
ney, liver, gallbladder, pericardium, and the “triple
warmer,” which represents the entire torso region. Each
organ has chi energy associated with it, and each organ
interacts with particular emotions on the mental level. As
there are twelve organs, there are twelve types of chi
which can move through the body, and these move
through twelve main channels or meridians. Chinese
doctors connect symptoms to organs. That is, symptoms
are caused by yin/yang imbalances in one or more or-
gans, or by an unhealthy flow of chi to or from one organ
to another. Each organ has a different profile of symp-
toms it can manifest.

THE FIVE ELEMENTS. Another basis of Chinese theo-
ry is that the world and body are made up of five main
elements: wood, fire, earth, metal, and water. These ele-
ments are all interconnected, and each element either
generates or controls another element. For instance,
water controls fire and earth generates metal. Each organ
is associated with one of the five elements. The Chinese
system uses elements and organs to describe and treat
conditions. For instance, the kidney is associated with
water and the heart is associated with fire, and the two
organs are related as water and fire are related. If the kid-
ney is weak, then there might be a corresponding fire
problem in the heart, so treatment might be made by
acupuncture or herbs to cool the heart system and/or in-
crease energy in the kidney system.

The Chinese have developed an intricate system of
how organs and elements are related to physical and men-
tal symptoms, and the above example is a very simple one.
Although this system sounds suspect to Western scientists,
some interesting parallels have been observed. For in-
stance, Western medicine has observed that with severe
heart problems, kidney failure often follows, but it still
does not know exactly why. In Chinese medicine, this con-
nection between the two organs has long been established.

MEDICAL PROBLEMS AND ACUPUNCTURE. In Chi-
nese medicine, disease as seen as imbalances in the
organ system or chi meridians, and the goal of any reme-
dy or treatment is to assist the body in reestablishing its

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

innate harmony. Disease can be caused by internal fac-
tors like emotions, external factors like the environment
and weather, and other factors like injuries, trauma, diet,
and germs. However, infection is seen not as primarily a
problem with germs and viruses, but as a weakness in
the energy of the body that is allowing a sickness to
occur. In Chinese medicine, no two illnesses are ever the
same, as each body has its own characteristics of symp-
toms and balance. Acupuncture is used to open or adjust
the flow of chi throughout the organ system, which will
strengthen the body and prompt it to heal itself.

A VISIT TO THE ACUPUNCTURIST. The first thing an
acupuncturist will do is get a thorough idea of a patient’s
medical history and symptoms, both physical and emo-
tional. This is done with a long questionnaire and inter-
view. Then the acupuncturist will examine the patient to
find further symptoms, looking closely at the tongue, the
pulse at various points in the body, the complexion, gen-
eral behavior, and other signs like coughs or pains. From
this, the practitioner will be able to determine patterns of
symptoms which indicate which organs and areas are
imbalanced. Depending on the problem, the acupunctur-
ist will insert needles to manipulate chi on one or more
of the twelve organ meridians. On these twelve meridi-
ans, there are nearly 2,000 points that can be used in
acupuncture, with around 200 points being most fre-
quently used by traditional acupuncturists. During an in-
dividual treatment, one to 20 needles may be used, de-
pending on which meridian points are chosen.

Acupuncture needles are always sterilized and
acupuncture is a very safe procedure. The depth of inser-
tion of needles varies, depending on which chi channels
are being treated. Some points barely go beyond superfi-
cial layers of skin, while some acupuncture points re-
quire a depth of 1-3 in (2. 5-7. 5 cm) of needle. The nee-
dles generally do not cause pain. Patients sometimes re-
port pinching sensations and often pleasant sensations,
as the body experiences healing. Depending on the prob-
lem, the acupuncturist might spin or move the needles,
or even pass a slight electrical current through some of
them. Moxibustion may be sometimes used, in which an
herbal mixture (moxa or mugwort) is either burned like
incense on the acupuncture point or on the end of the
needle, which is believed to stimulate chi in a particular
way. Also, acupuncturists sometimes use cupping, dur-
ing which small suction cups are placed on meridian
points to stimulate them.

How long the needles are inserted also varies. Some
patients only require a quick in and out insertion to clear
problems and provide tonification (strengthening of
health), while some other conditions might require nee-
dles inserted up to an hour or more. The average visit to
an acupuncturist takes about 30 minutes. The number of

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

visits to the acupuncturist varies as well, with some con-
ditions improved in one or two sessions and others re-
quiring a series of six or more visits over the course of
weeks or months.

Costs for acupuncture can vary, depending on
whether the practitioner is an MD. Initial visits with non-
MD acupuncturists can run from $50-$100, with follow-
up visits usually costing less. Insurance reimbursement
also varies widely, depending on the company and state.
Regulations have been changing often. Some states au-
thorize Medicaid to cover acupuncture for certain condi-
tions, and some states have mandated that general cover-
age pay for acupuncture. Consumers should be aware of
the provisions for acupuncture in their individual policies.

Precautions

Acupuncture is generally a very safe procedure. If a
patient is in doubt about a medical condition, more than
one physician should be consulted. Also, a patient should
always feel comfortable and confident that their
acupuncturist is knowledgable and properly trained.

Research & general acceptance

Mainstream medicine has been slow to accept
acupuncture; although more MDs are using the technique,
the American Medical Association does not recognize it as
a specialty. The reason for this is that the mechanism of
acupuncture is difficult to scientifically understand or
measure, such as the invisible energy of chi in the body.
Western medicine, admitting that acupuncture works in
many cases, has theorized that the energy meridians are
actually part of the nervous system and that acupuncture
relieves pain by releasing endorphins, or natural pain
killers, into the bloodstream. Despite the ambiguity in the
biochemistry involved, acupuncture continues to show ef-
fectiveness in clinical tests, from reducing pain to alleviat-
ing the symptoms of chronic illnesses, and research in
acupuncture is currently growing. The Office of Alterna-
tive Medicine of the National Institute of Health is cur-
rently funding research in the use of acupuncture for treat-
ing depression and attention-deficit disorder.

Training & certification

Medical acupuncture has evolved in America which
uses traditional methods mainly as surgical techniques
and pain management, and not as part of Chinese medi-
cine overall. Medical acupuncture is performed by an
MD or an osteopathic physician (DO). Currently 23
states allow only this type of acupuncture. Practitioners
get their training as part of conventional medical school
programs. As any MD can legally perform acupuncture,

Acupuncture

Ademetionine

KEY TERMS

Acupressure — Form of massage using acupunc-
ture points.

Auricular acupuncture — Acupuncture using only
points found on the ears.

Chi — Basic life energy.

Meridian — Channel through which chi travels in
the body.

Moxibustion — Acupuncture technique which
burns the herb moxa or mugwort.

Tonification — Acupuncture technique for

strengthening the body.

Yin/Yang — Universal characteristics used to de-
scribe aspects of the natural world.

The American Academy of Medical Acupuncture
(AAMA) was chartered in 1987 to support the education
and correct practice of physician-trained acupuncturists.
Its members must be either MDs or DOs who have com-
pleted proper study of acupuncture techniques. Address:
5820 Wilshire Blvd., Suite 500, Los Angeles, CA 90036,
(323) 937-5514, http://medicalcupuntcture.org

For traditional acupuncturists. The National Com-
mission for Certification of Acupuncturists (NCCA) con-
ducts certification exams, promotes national standards,
and registers members. Most states that license acupunc-
turists use the NCCA standards as certification. Address:
11 Canal Center Plaza, Ste. 300, Alexandra, VA 22314,
(703) 548-9004, http://www.nccaim.org.

The American Association of Acupuncture and Ori-
ental Medicine (AAAOM) is the largest organization for
practitioners, with more than 1,600 members. Address:
1925 W. County Rd B2, Roseville, MN 55113, (651) 631-
0204, http://www.aaaom.org.

Resources

BOOKS

Fleischman, Dr. Gary F. Acupuncture: Everything You Ever
Wanted To Know. New York: Barrytown, 1998.

Kakptchuk, Ted. The Web That Has No Weaver: Understanding
Chinese Medicine. New York: Congdon and Weed, 1983.
Requena, Yves, MD. Terrains and Pathology in Acupuncture.
Massachusetts: Paradigm, 1986.

PERIODICALS

American Journal of Acupuncture. 1840 41st Ave., Suite 102,
P.O. Box 610, Capitola, CA 95010.

Assefi, Nassim. “Acupuncture for Fibromyalgia.” Alternative
Medicine Alert. (February 2002): 13.

Savage, Lorraine. “Grant to Study Acupuncture”s Effective-
ness on Patients Suffering from Substance Abuse.”
Healthcare Review. (March 19, 2002): 16.

OTHER

American Association of Oriental Medicine, http://www.aaom.
org / (December 28, 2000).

North American Society of Acupuncture and Alternative Medi-
cine. http://www.nasa-altmed.com/ (December 28, 2000).

Douglas Dupler
Teresa G. Odle

Acute homeopathic remedies see

Homeopathy, acute prescribing

ADD see Attention-deficit hyperactivity
disorder

Addiction see Alcoholism; Substance abuse
and dependence

Ademetionine

Description

Ademetionine, also known as SAMe, is a specific
form of the amino acid methionine known as S-adeno-
syl-methionine. The body manufactures it, and it is found
in most tissues of the body. Ademetionine is essential for
the formation of glutathione, a water-soluble peptide that
helps the body fight free radicals. SAMe also helps the
liver to process fats (protecting against a fatty liver) and is
believed to play a role in protecting the body from heart
disease. SAMe is a methyl donor, which means that it
provides other molecules with methyl groups that are
critical to their metabolism. In general, ademetionine
raises the level of functioning of other amino acids in the
body. Severe deficiencies of SAMe can cause problems
with other important body functions, such as secretion of
important hormones like melatonin, which plays a key
role in regulating sleep and circadian rhythms.

General use

The synthetic formula of ademetionine has been
hailed as an anti-aging formula because it is such a power-
ful antioxidant. Antioxidants are substances that counter-
act the damaging effects of free radicals in human tissue.
Ademetionine has been widely popularized recently, but it
is not a recent discovery. In fact it was discovered in Italy
in 1952, and has been widely researched over the past few
decades. In the 1970s, Italian researchers investigating its

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

properties as a treatment for schizophrenia discovered
that it also had definite antidepressant properties. Ademe-
tionine became a useful treatment only during the 1990s,
however, when scientists found a way to stabilize it for re-
search purposes. After that technological development,
ademetionine could be sold as a medical supplement.

Ademetionine has been used successfully to treat de-
pression, arthritis, schizophrenia, liver disease, periph-
eral neuropathy, and other illnesses. Many people who
have these illnesses, particularly schizophrenia, peripher-
al neuropathy, and myelopathy, may have low blood lev-
els of folic acid, vitamin B 12 , and certain amino acids,
particularly SAMe and those with which it interacts.

Pain relief

The effectiveness of ademetionine has been studied
in clinical trials with human subjects. One six-week study
compared SAMe to transcutaneous electrical nerve stim-
ulation (TENS), which is a popular form of pain relief in
Europe. SAMe proved to be a more effective treatment.

Liver function

SAMe has been found to restore normal liver func-
tion in patients suffering from a variety of liver disease,
both alcohol induced and other. It has also been found to
reverse liver damage resulting from the ingestion of vari-
ous drugs and chemical agents (paracetamol and others).

Depression

Several clinical trials found that ademetionine has a
rapid effect on depression. Within double blind trials,
ademetionine was found to have a markedly greater ef-
fect than placebos, with only mild side effects. Although
the substance seems to work surprisingly well on most
forms of depression, a study done at Northwick Park
Hospital in Harrow, England, suggests that it is more ef-
fective for endogenous depression (depression that does
not have an obvious external cause) than for neurotic de-
pression (depression that has an identifiable cause).

These findings may be related to the fact that pa-
tients suffering from endogenous forms of depression are
often found to have low levels of this amino acid. This is
a particularly exciting discovery, because endogenous
depression is the most difficult form to treat. Ademetion-
ine was found to be particularly helpful to post-
menopausal women suffering from depression. Some
practitioners are suggesting the use of ademetionine in
conjunction with other antidepressants to shorten the pe-
riod between the beginning of antidepressant treatment
and the patient’s sense of improvement. Since ademetio-
nine generally has fewer side effects than many antide-
pressants, it may be preferable to use it alone.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Peripheral neuropathy

Ademetionine has been used successfully to treat
cases of peripheral neuropathy that had not previously
responded to treatment with vitamin B 12 (cyanocobal-
amin). This is an important discovery, because peripheral
neuropathy is difficult to treat.

Migraine

Ademetionine has been found to be a useful
painkiller. Over the long term, it may work less rapidly
than some other analgesics, but it does not have the high
incidence of gastrointestinal disturbance that results
from taking ibuprofen, for example. Ademetionine may
be the answer for patients who also suffer from GI tract
diseases and cannot safely take other analgesics.

Fibromyalgia

Fibromyalgia is characterized by persistent muscle
pain and aching that has no apparent cause. One Scandi-
navian study noted that patients with fibromyalgia who
took SAMe showed some improvement.

Osteoarthritis

Studies have shown that osteoarthritis patients not
only experienced less pain while taking ademetionine,
but that the depression that often accompanies the dis-
ease was less evident. Ademetionine is also less toxic
than the allopathic drugs used to treat such diseases.

Alzheimer’s and Parkinson’s diseases

Ademetionine has been shown to treat nerve dam-
age and depression sometimes as effectively as standard
pharmaceutical drugs without serious side effects. Some
believe that SAMe may increase the effectiveness of lev-
odopa, which is the drug most often prescribed for
Parkinson’s disease.

Preparations

Ademetionine is available in preparations for oral,
intravenous, and intramuscular administration. Treat-
ment with ademetionine should always be monitored by
a qualified practitioner.

For liver function: 200 mg of ademetionine can be
taken twice daily, gradually raising the dosage to 400 mg
three times daily. Patients with peripheral neuropathy
have been given dosages as high as 1600 mg daily.

For depression the following program may be effec-
tive: 200 mg taken twice daily for the first two days. For the
third to the ninth day, dosage may be increased to 400 mg
twice daily, and for days ten to nineteen, 400 mg should be

Ademetionine

Adie's pupil

taken three times daily. After the twentieth day, the dosage
should be stabilized at 400 mg four times daily. Some prac-
titioners recommend doses as high as 1600 mg daily.

Migraine and fibromyalgia sufferers can take 200
mg of ademetionine twice daily, increasing to 600 mg
doses. Osteoarthritis patients may be advised to take as
much as 1200 mg daily for effective treatment.

Precautions

Patients with serious diseases such as those men-
tioned above should seek the help of a qualified practition-
er. It is significant, however, that no patient has ever
dropped out of studies related to ademetionine testing due
to side effects, even though it has been administered in
high doses and in all forms, i.e., orally, intravenously, and
intramuscularly. In addition, antidepressants, particularly
the tricyclics, may cause accidental or intentional overdos-
es. SAMe is also free of the hazard of potential addiction.

One possible drawback to ademetionine treatment is
its cost. A month’s supply may cost between $60 and
$100. This is about the same as the cost of many antide-
pressants, but ademetionine is less likely to be covered
by medical insurance.

Side effects

SAMe is not suitable for patients with bipolar disor-
der, as it may amplify the manic phase of the condition.

The only side effects observed with SAMe in clini-
cal trials were mild gastrointestinal distress.

In patients who are deficient in the B vitamins, no-
tably B 6 and B 12 , there is a danger that SAMe may break
down to form homocysteine, an amino acid that has been
linked to heart disease and stroke. If the patient’s levels
of B vitamins are maintained, however, the body will be
able to convert the homocysteine back into methionine
and glutathione, and the use of SAMe will not increase
the risk of heart disease.

Interactions

Ademetionine should not be used in conjunction
with prescription medications for depression, as it in-
creases their effects. It should also not be taken with
MAO inhibitors, as it may produce a toxic reaction. Last-
ly, it should not be given to pregnant or lactating women.

Resources

PERIODICALS

Fournier, Isabelle, et al. “Folate Deficiency Alters Melatonin

Secretion in Rats.’’ The Journal of Nutrition (September

2002): 2781.

KEY TERMS

Analgesic — Any remedy that relieves pain.
Fibromyalgia — Chronic muscular or nerve pain
that has no obvious cause.

Free radicals — Unstable molecules resulting from
oxidation that cause damage to human tissue, in-
cluding signs of aging.

Glutathione — A water-soluble peptide composed
of cysteine, glycine, and glutamic acid. It func-
tions as an antioxidant. The body uses ademetion-
ine to form glutathione.

Myelopathy — Any disease of the spinal cord or
bone marrow.

Peripheral neuropathy — Damage to the nerve
endings of the hands and feet, often as a result of
diabetes.

Transcutaneous electrical nerve stimulation
(TENS)— A treatment for chronic pain that in-
volves the use of a self-operated portable device.
The device sends electrical impulses through elec-
trodes placed over the painful area.

ORGANIZATIONS

American Holistic Medicine Association. http://www.holistic
medicine.org/index.html.

The Linus Pauling Institute, http://osu.orst.edu/dept/lpi/
resagenda/timeline.html.

Patricia Skinner
Teresa G. Odle

ADHD see Attention-deficit hyperactivity
disorder

Adie's pupil

Definition

Adie’s pupil is a neurological condition of unknown
origin with an unusual, asymmetric presentation known
as anisocoria, an inequality in the size of the pupils of
the eyes. It is believed to be a result of damage to the
nerve innervating a muscle of the eye known as the cil-
iary body. Alternately, the problem may be located at the
ciliary ganglion, a kind of nerve junction structure from

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

which the nerve to the ciliary body runs. Accommoda-
tion, or the adjustment of the eye for distance, is affect-
ed, as well as pupillary dilation and contraction, the abil-
ity of the eye’s iris to open or close in response to ambi-
ent light. Adie’s pupil primarily affects women from 20
to 40 years of age. It is considered to be a benign condi-
tion with no known cure. When Deep Tendon Reflexes
(DTRs) of the legs — knee and ankle jerks — are also af-
fected, accompanied by symptoms including localized,
discreet areas of the skin that do not sweat, postural hy-
potension (low blood pressure related to sudden standing
or rising), and unsteady heart rhythms, the condition is
referred to as Adie’s syndrome.

Description

The eyes are a complex anatomical and neurological
unit. The outer surface of each eye is protected by a
cornea — a normally clear cover that initiates the bending
of light rays into the eye. Beneath the cornea lies the col-
orful iris, a membrane containing two muscles capable of
contracting and dilating like the diaphragm of a camera
as it floats in the “aqueous humor.” Beneath the iris, the
lens, under the influence of the ciliary body, further bends
and directs the incoming light back to the retina, where it
is received and transferred through the optic nerve at the
back of the eye to the visual center of the brain (the visual
cortex) at the back of the head. From the visual cortex, in-
struction based on whether the object of vision is near or
far, and whether the surrounding light is bright or dim,
goes back to the muscles of the eye — the ciliary body —
through the ciliary ganglion, and results in a re-shaping
of the lens (accommodation) and an opening or closing of
the pupil (pupillary reaction), as needed, in order to focus
more sharply. Under normal circumstances, brightness
and accommodation for near vision will result in contrac-
ture of the ciliary body and the pupil, whereas darkness
and accommodation for distance normally results in a re-
laxation of the ciliary body and dilation of the pupil. For
a person with Adie’s pupil, however, nerve signals arriv-
ing at the ciliary body of one eye are weaker than to the
other eye, believed to be a result of damage to or degener-
ation of the ciliary ganglion or the ciliary body. The af-
fected eye muscle is unable to contract, dilate, or focus
with the same strength and speed as the unaffected eye.
Relative to the opposite, unaffected eye, in normal day-
light the pupil of the affected eye will be larger whereas,
in a quickly darkened room, the affected eye will be
smaller. Furthermore, the nerve from the ciliary ganglion
to the ciliary body has 30 fibers dedicated to changing the
shape of the lens and only one fiber dedicated to dilating
the iris. As a result, a person with Adie’s pupil is even less
able to dilate their pupil than to focus. Some research
suggests that as the person ages, the ability to dilate grad-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ually lessens to the point that the eye may have a smaller
(constricted) pupil almost all the time.

The list of other names by which Adie’s Pupil is
known includes: Adie’s Tonic Pupil; Tonic Pupil Syn-
drome; Holmes-Adie Syndrome and Adie-FIolmes Syn-
drome; Psuedotabes, Papillotonic Psuedotabes, and
Psuedotabes pupillotonica; Kehrer-Adie Syndrome;
Markus’ Syndrome; Weill’s Syndrome, Weill-Reys Syn-
drome, and Weill-Reys-Adie Syndrome; Psuedo- Argyll
Robertson Pupil, Psuedo-Argyll Robertson Syndrome,
and Nonluetic Argyll-Robertson Pupil; Myotonic Pupil
and Myotonic Pupillary Reaction; Saenger’s Syndrome;
and. Constitutional areflexy-tridoplegia interna. These
many names derive from the lengthy history of study of
this condition, beginning in 1813, when James Ware, a
London ophthalmologist, or medical doctor specializing
in the eyes, described some of these symptoms. Dr. Adie
added to an already long list of doctors who had studied
it, when in 1931 he described the condition as self-gen-
erating. It was first referred to as Adie’s syndrome in
1934 by the French neurologist, Jean-Alexandre Barre.

Causes & symptoms

Some external causes such as trauma or surgery to the
eye, and some internal causes such as an unknown virus,
an inflammatory condition, or a familial tendency have
been suggested. In the case of trauma or surgery, it is be-
lieved that the damaged or cut nerve fails to regrow with all
fibers running in the same direction for proper reattach-
ment to the ciliary body. The propensity to affect women
between 20 and 40 years of age more than men of all ages
promoted one doctor to speculate that it may be, or related
to, an autoimmune disorder, especially when the individual
lives a stressful lifestyle and other related family members
have suffered neurological diseases or disorders. Caffeine,
a high sugar diet, or an imbalance in essential fatty acids
that are important in maintaining nerve health may also be
factors, but no studies have been identified supporting this
hypothesis. Occasionally similar symptoms are seen in
syphilitic persons; however, one source notes that as early
as 1914, syphilis was ruled out as the cause of this condi-
tion. This unusual pupillary reflex, also known as “tonic
pupil,” because it is slow to change, may also be associated
with diabetes, alcoholism, a herpes viral infection, or a
cranial arterial condition known as giant cell arteritis.
Symptoms, in addition to the slow-to-respond, differently
sized pupil of the affected eye, may include headache, as a
result of the strain on the vision, a sensitivity to bright
lights, and loss of some reflexes, especially the knee-jerk.

Diagnosis

Diagnosis is made on the basis of a thorough history
and physical examination, followed by tests to rule out

Adie's pupil

other suspected causes according to the persons history.
An examination of the eye using a “slit lamp” — an in-
tensely bright lamp shielded by a shade with a slit it it —
reveals undulating, irregular, worm-like movements with
a segmented or ratcheted appearance in the iris of the af-
fected eye, uncoupled to movements in the iris of the un-
affected eye. A positive (hypersensitive) reaction to pilo-
carpine drops, an alkaloid substance from the jaborandi
tree that causes the otherwise slow-to-constrict pupil to
constrict intensely, is considered diagnostically additive.

Treatment

No specific treatments were noted; however, treat-
ments that strengthen or protect the nervous system
might be helpful, treatments such as the B complex of
vitamins, antioxidants including Vitamins C and E,
alpha lipoic acid, and Superoxidedismutase (S.O.D.),
and dietary modifications of fat that have been found
helpful in multiple sclerosis, another condition due to
damage to nerve pathways affecting nerve transmission,
including intake of essential fatty acids and reduced in-
take of trans-fatty acids and hydrogenated fats. Dietary
reductions in caffeine and sugar, including sugar substi-
tutes like aspartame, may be helpful. Lifestyle practices
that reduce stress and tone the parasympathetic nervous
system, such as yoga or massage, may be helpful.

Allopathic treatment

No specific treatments were noted, however cosmet-
ic use of dilute pilocarpine drops to constrict the tonic
pupil was suggested.

Prognosis

Partial recovery of function is more likely if the initi-
ating damage was to the ciliary body rather than to the
ciliary ganglion. As a result of the number of fibers dedi-
cated to each from the ciliary ganglion, recovery of inner-
vation to the lens controlling function is more likely than
recovery of the pupillary reactive function. One source
noted also that reinnervation may be slow, segmental and
irregular, similar to the ocular symptoms themselves.

Prevention

No preventative measures were noted.

Resources

BOOKS

Bates, Barbara. A Pocket Guide to Physical Examination and

History Taking. Philadelphia: Lippincott, 1991.

Mareib, Elaine N. Essentials of Human Anatomy and Physiolo-
gy. 3rd ed. Benjamin/Cummings, 1991. pp. 219

KEY TERMS

Accommodation — The adjustment made through
a change in shape of the lens allowing for vision
of objects near and far.

Aqueous humor — A clear fluid in the posterior
and anterior chambers of the eye that moves from
back to front and exits the eye through a small
canal into the venous system.

Knee and ankle jerk reflexes — Normal reflexes
elicited usually by testing with a reflex hammer
and demonstrating, by being present, a healthy
and intact nervous system.

Pupillary reaction — The normal change in the size
of the pupil due to the amount of ambient light.
Under normal circumstances, both pupils respond
simultaneously and equally.

Tonic pupil — A pupil that is slow to change.

Pavan-Langston, Deborah. Manual of Ocular Diagnosis &
Therapy, 4th ed. Little, Brown & Co., 1995, pp. 336.

Simon, Roger P., Michael J. Arnihoff, and David A. Greenberg.
Clinical Neurology, 4th ed. Stamford: Appleton & Lange,
1999, pp. 145.

Tasman, M.D., William. Duane’ s Clinical Ophthalmology.
2.15. Philadelphia: Lippincott, 1992. pp. 12.

Vander, M.D., Arthur J., James H. Sherman, Ph.D., and
Dorothy S. Luciano, Ph.D. Human Physiology, Mechanics
of Body Function, 5th ed. McGraw Hill, 1990, pp. 310.

Vaughn, Daniel, Taylor Asbury, and Paul Riordan-Eva. General
Ophthalmology, 15th ed. Stamford: Appleton & Lange,
1999, pp. 267.

OTHER

Enersen, Ole Daniel. Adie’s syndrome. 1994-2001. [cited May
12, 2004], <http://www.whonamedit.com/synd.cfm/1837.
html>.

Genetic Information and Patient Services, Inc. (GAPS) “The
Gaps Index.” Adie Syndrome, [cited May 12, 2004].
<http://www.icomm.ca/geneinfo/adie.htm>.

World & Medicine — Ophthalmology. Encyclopaedia of Oph-
thalmology — Greatest Links’ Collection. “Adie's syn-
drome." In Principles of Neurology, 6th ed., p.279. [cited
May 12, 2004]. <http://wmed.narod.ru/w_ophth/diseases/
o_mot il/om_06 ,htm> .

Katherine E. Nelson, N.D.

African medicine see Traditional African
medicine

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

African pygeum

Description

African pygeum (Primus africana), also known as
pygeum africanum, pygeum, and African plum tree, is an
evergreen tree native to higher elevations of southern
Africa. A 150 ft (46 m) tall member of the Rose family
(Rosacea), pygeum has been found to be useful in treat-
ing prostate problems, particularly benign prostatic hy-
pertrophy (BPH), a condition affecting many men.

The tree’s bark contains an oil with many active in-
gredients; waxes, fatty acids, and other less familiar
compounds. Pygeum’s principal biological activity is
traced to a “phytosterol” compound known as beta-sitos-
terol. Phyto (plant) sterols are structurally similar to, but
much less efficiently absorbed from the diet than, cho-
lesterol. The biological strength of phytosterols, howev-
er, is similar to that of hormones; therefore, a very small
amount seems sufficient to initiate a response. Pygeum’s
phytosterols are anti-inflammatory. Pygeum also reduces
edema (the swelling caused by an excess of fluids), re-
duces levels of the hormone prolactin, lowers and in-
hibits cholesterol activity within the prostate. Prolactin,
whose levels are increased by drinking beer, stimulates
testosterone uptake by the prostate, reportedly increasing
levels of a metabolite responsible for prostatic cell in-
creases, dihydrotestosterone (di-hydro-testosterone),
(DHT). Cholesterol is reported to increase the influence
of DHT. BPH imlies two prostate changes: increased
size and increase tissue density. These changes cause
symptoms of frequent urge to urinate small volumes, re-
duced prostatic secretions, reduced bladder emptying.
Incomplete bladder emptying increases risk of bladder
infections, edema and inflammation, and possibly, pro-
static cancer. Blood sugar levels and immune function
have also been found to improve.

In summary, african pygeum’s medicinal actions in-
clude:

• anti-inflamation

• reducing edema of the prostate

• inhibit cellular increase

• improving the natural flow of prostatic secretions

• lowering cholesterol

• regulating insulin activity, thereby affecting blood
sugar levels

• regulating the immune system

Although pygeum’s use is relatively new to the
United States, it has been imported from Africa to Eu-
rope since the 1700s, and is still used today as a major

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

treatment for BPH. Europeans learned of this plant’s
usefulness in treating what was then known as “old
man’s disease”. It continues to be a widely popular in
Europe as a remedy for BPH, especially in France where
the use of African pygeum for BPH is reported to be 'ns
about 80%. |

General use

Pygeum is Primarily used to treat benign prostatic
hypertrophy or BPH, a condition which affects men as
early as their 40s, but increasingly with age: 30% of fifty
year olds; 50% of sixty year olds; and nearly 80% of
men 70 and older. It has been found to be of use in the
related condition of chronic prostatitis, with and without
prostate related sexual dysfunction, and infertility due
to reduced prostatic secretions. Due to actions as an im-
mune system “up regulator” and anti-inflammatory,
pygeum is also being studied for use with other treat-
ments for hepatitis C and HIV.

According to one source, in a double blind placebo
controlled study involving 263 men on a dose of 1 00 mg
per day of African pygeum extract for 60 days, the fol-
lowing improvements versus controls were observed:

•31% decrease in “nocturia,” or night-time frequency

• 24.5% decrease in “residual urine,” the amount of urine
left in the bladder after urination

• 50% increase in overall relief and feeling of wellbeing.

Two-thirds of the group using Pygeum reported
feeling satisfaction. This was twice the improvement re-
ported by the control group on placebo.

In a study on chronic prostatitis, 60% of men with
urinary tract infections and nearly 80% of men without
infections reported improvements using 100 mg of
Pygeum extract for five to seven weeks. In the treatment
of sexual dysfunction due to chronic prostatitis, a dose of
200 mg for 60 days, with or without an antibiotic, pro-
duced improvements in urination and sexual function.
The few small and relatively short clinical trials of
pygeum in the treatment of Hepatitis C and HIV+ infec-
tions have been statistically significant; further trials are
under way in South Africa.

Preparations

Since the 1960s, in Europe, the most commonly used
form is the standardized herbal extract. The process is
highly technical and, for Pygeum, is designed to target
extraction of the active oils using a sequence of laborato-
ry extraction procedures. Standardization is the process
whereby the targeted active ingredients are quantified and

• 17.2% increase in urine flow

African

African pygeum

concentrated to a consistent therapeutic dose. The widely
modern use of the extract form of African pygeum in-
stead of the whole plant may derive from the discovery
that the plant’s activity is primarily due to its alcohol sol-
uble phytosterols. A month’s supply in capsules at a daily
dosage of 100 mg, standardized to contain approximately
14% of the active beta-sitosterol ingredient, costs be-
tween $40 and $50. In some preparations, synergistic in-
gredients such as amino acids, other herbs, and vitamins
or minerals, may be included. Studies cited used dosages
of 100 mg daily; however, one study compared and found
two dosages of 50 mg versus one dose of 100 mg per day
had the same therapeutic effect.

Precautions

Precautions noted include recommendations to seek
the guidance of a healthcare professional, and not to self
treat. Pygeum may cause a hormonal shift, and is not rec-
ommended for children. Also noted: pygeum may require
several weeks to months to make a noticeable difference;
studies noted reported benefits at ranges of five to eight
weeks. One source reported pygeum relieves symptoms
but does not reduce prostatic size. Another study specifi-
cally stated that the active components of pygeum have
symptom reversal and prevention characteristics.

Side effects

Pygeum appears to be relatively safe and non-toxic.
One report noted rare occurrences of diarrhea, dizziness,
disturbed vision, gastric pain and constipation. One
study reported satisfactory safety profiles after 12 months
of using 100 mg daily in 174 subjects. In animal studies it
was reported that dogs and rats given amounts equivalent
to more than 500 times the therapeutic dose showed no
adverse effects, and amounts equivalent to 50 times the
therapeutic dose had no effect on fertility. In vivo and in
vitro studies showed no carcinogenic effects. In fact,
pygeum ’s constituents have been found to be anti-carcino-
genic. The National Institute of Health (NIH), in 2002, es-
tablished a grant for a randomized controlled clinical
study involving 3,100 men, in order to learn more about
the medical potential of this alternative therapy, due to in-
creased BPH diagnoses as the population ages.

Interactions

Synergistic supplements may facilitate benefits. One
report advised dietary adjustments to enhance beneficial
result. Dietary recommendations to improve prostatic
health included avoiding the irritants of coffee and to-
bacco; eating pumpkin seeds for their zinc and Omega 3
anti-inflammatory content; increasing other dietary

KEY TERMS

Benign prostatic hypertrophy (BPH) — A condition
in many men affecting the prostate, wherein in-
creased number and size of cells produces many
urinary related symptoms.

Beta-sitosterol — A plant lipid with considerable
biological activity; even in very amounts it is
found to be anti-inflammatory and to have posi-
tive effects in treating BPH.

Dihydrotestosterone (DHT) — A testosterone
metabolite implicated in the increase in size and
number of prostatic cells.

Double blind placebo controlled study — A study
in which neither the patient nor the drug adminis-
trator knows who is receiving the trial drug and
who the placebo.

Metabolite — A by product of the physical and
chemical change process known as metabolism.
Prolactin — A hormone found in lactating women,
and in men. Levels are increased by drinking beer.

Prostatic secretions — Normal secretions of the
prostate gland intended to nourish and protect
sperm, improving fertility.

Standardized herbal extract — An herbal product
created by using water or alcohol to dissolve and
concentrate the active ingredients, which are then
quantified for medicinal pharmacological effect.
Synergistic — Describes an association which im-
proves the effectiveness of members of the associ-
ation.

Testosterone — The primary male reproductive
hormone. Uptake into prostatic tissues is stimulat-
ed by prolactin; its DHT metabolite stimulates
prostatic cell increases.

sources of Omega 3s, including the cold water fishes
salmon, sardines, and mackerel; taking antioxidants and
a good multiple vitamin; and the synergistic herb saw
palmetto ( Serenoa repens ), said to be more effective
than the pharmaceutical for BPH, Proscar, at inhibiting
the conversion of testosterone to its metabolite DHT, im-
plicated in prostatic cell increases. Vitamins E (400 IU)
and B 6 (50-100mg) were suggested to synergistically re-
duce prolactin levels. It was also noted that 200 meg of
selenium daily reduce the risk of prostate cancer.

No unfavorable interactions were noted. Common
sense might suggest that any lifestyle habit that aggra-
vates prostate health, for example, a high cholesterol,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

high fat, high red meat, low fiber diet, frequent and high
intake of beer, and lack of exercise may decrease the ef-
fectiveness of pygeum or other medications indicated for
prostate health. Because pygeum has been found to up-
regulate immunity, its use may be contra-indicated
where immune system upregulation is undesirable. No
unfavorable herb-drug interactions have been noted.

Resources

BOOKS

Chevallier, Andrew. The Encyclopedia of Medicinal Plants.
D.K. Publishing. 1996.

PERIODICALS

Miller, N.D., Alan L. “Benign Prostatic Hyperplasia, Nutrition-
al and Botanical Therapeutic Options." Alternative Medi-
cine Review 1.1. (2001).

Patrick, N.D., Lyn. “Hepatits C: Epidemiology and Review of
Complementary/ Alternative Medicine Treatments.” Alter-
native Medicine Review. (2001).

OTHER

Brown, Don. "The Male Dilemma: Relief For Prostate Prob-
lems.” Total Health 12 June 1990. [cited May 7, 2004].
<http://galenet.galegroup.com/servlet/HWRC> Record#
A8994271>.

Iyker, Robert. “Men’s Health: Straight Talk On Your Health
and Life.” Natural Health April 1999. <http://www.find
articles.com>.

"The National Institutes of Health is Proceeding on a Study to
Determine if the Dietary Supplement Ingredients. . .Saw
Palmetto and Pygeum.” Food Chemical News 43.52. Feb-
ruary 11, 2002. [cited May 7, 2004]. <http://galenet.
galegroup.com/servlet/HWRC>.

"Pygeum africanum ( Primus Africana) (African plum tree).” Al-
ternative Medicine Review 7.1. February 2002. [cited May
7, 2004], <http://galenet.galegroup.com/servlet/HWRC>.

Katy Nelson, N.D.

Agastache

Description

Agastache is a genus of plants found almost world-
wide. Different species are used in several native cul-
tures for healing. The best know of these is Agastache
rugosa, also called the giant hyssop, wrinkled giant hys-
sop, Korean mint, or in Chinese Huo xiang.

Agastache rugosa is a perennial or biennial plant that
grows to a height of 4 ft (1.2 m). It is native to China, but
has spread to Japan, Korea, Laos, and Russia. It grows
wild on sunny hillsides and along roads, but also can be

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

cultivated in backyard gardens. The highly aromatic
leaves and purple or red flowers are used for healing.

Several other species of agastache found in other
parts of the world are used in healing. These include A.
nepetoides (yellow giant hyssop ), A. foeniculum (anise
hyssop), and A. mexicana. Leaf and flower color vary
considerably among the different species. Many species
of agastache also are grown commercially in the United
States for landscaping. In southern China and Taiwan,
Pogostemon cahlin , a relative of Pogostemon patchouli ,
the Indian plant that produces patchouli oil, is used inter-
changeably with A. rugosa.

General use

A. rugosa is used extensively in Chinese herbalism.
It’s first recorded use dates from about 500 a.d. It is asso-
ciated with the lungs, spleen, and stomach and is classi-
fied as having a warm nature and an acrid and aromatic
taste. Traditionally, agastache has been associated the
treatment of several different sets of symptoms. It has
long been used to treat stomach flu, stomachache, nau-
sea, vomiting, diarrhea, abdominal bloating, and ab-
dominal pain. It is combined with Scutellaria (skullcap)
to treat morning sickness in pregnant women. It is also a
component of formulas that improve digestive balance by
aiding the absorption of nutrients and intestinal function.

In Chinese herbalism, A. rugosa is also used to treat
summer flu or summer colds with accompanying low
fever, feelings of fullness in the chest, and headache. It
is also used to treat dark urine and a feeling of heaviness
in the arms and legs. A lotion containing A. rugosa is ap-
plied externally to treat fungal infections.

Other cultures independently have discovered simi-
lar uses for other species of agastache. A. mexicana is
grown in Mexico and used to treat gastrointestinal up-
sets, nervous, and cardiovascular ailments. The leaves of
A. nepetoides are used by Native Americans to treat skin
rashes caused by poison ivy. A. foeniculum leaves have a
strong licorice taste (accounting for its English name,
anise hyssop). These leaves can be brewed in a tea to
treat coughs, fever, and colds.

Although rigorous scientific testing of the healing
claims made for agastache is scarce, one 1999 study
done at Seoul National University in Korea has shown
that in test tube experiments an extract of the root of A.
rugosa significantly inhibited the action of certain pro-
teins associated with the reproduction of the HIV virus.

Preparations

Agastache can be prepared alone as a tea, incorpo-
rated into a lotion, or prepared as a pill. The leaves are

Agastache

Aging

KEY TERMS

Biennial — Biennial plants take two years to com-
plete their life cycle and produce fruit and flowers
only in the second year.

Qi — Qi is the Chinese term for the vital life force
that permeates the body. According to traditional
Chinese medicine, qi collects in channels in the
body and can be moved and redirected through
treatments and therapies.

strongly aromatic, but lose this quality with prolonged
boiling (over 15 minutes). Therefore agastache is added
last in formulas that must be boiled.

The best know formulas using agastache are agas-
tache formula and Huo Xiang Zheng Qi Wan, or agas-
tache qi-correcting formula. Agastache formula is used
to harmonize the stomach. It is given as treatment for
gastrointestinal upsets with chills, fever, and diarrhea.

Huo Xiang Zheng Qi Wan regulates qi and treats
seasonal gastric disorders, especially those occurring
during hot, humid weather. This formula is commercial-
ly available in both tablet and liquid form. Other cultures
prepare agastache either as a tea to be drunk, or use the
leaves externally.

Precautions

Agastache has a long history of use with no substan-
tial reported problems.

Side effects

No side effects have been reported with the use of
agastache.

Interactions

Agastache is often used in conjunction with other
herbs with no reported interactions. Since agastache has
been used almost exclusively in Chinese medicine, there
are no studies of its interactions with Western pharma-
ceuticals.

Resources

BOOKS

Chevallier, Andrew. Encyclopedia of Medicinal Plants. Boston:
DK Publishers, 1996.

Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.

Zhu, Chun-Han. Clinical Handbook of Chinese Prepared Med-
icines. Brookline, MA: Paradigm Publications, 1989.

ORGANIZATIONS

American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433

Tish Davidson

Aging

Definition

Starting at what is commonly called middle age, op-
erations of the human body become more vulnerable to
daily wear and tear. There is a general decline in physical,
and possibly mental, functioning. In the Western coun-
tries, the length of life often extends into the 70s. Howev-
er, the upward limit of the life span can be as high as 120
years. During the latter half of life, an individual is more
prone to problems with the various functions of the body,
and to a number of chronic or fatal diseases. The cardio-
vascular, digestive, excretory, nervous, reproductive, and
urinary systems are particularly affected. The most com-
mon diseases of aging include Alzheimer’s, arthritis, can-
cer, diabetes, depression, and heart disease.

Description

Human beings reach a peak of growth and develop-
ment during their mid 20s. Aging is the normal transition
time after that flurry of activity. Although there are quite
a few age-related changes that tax the body, disability is
not necessarily a part of aging. Health and lifestyle fac-
tors, together with the genetic makeup of the individual,
determine the response to these changes. Body functions
that are most often affected by age include:

• Hearing, which declines especially in relation to the
highest pitched tones.

• The proportion of fat to muscle, which may increase by
as much as 30%. Typically, the total padding of body
fat directly under the skin thins out and accumulates
around the stomach. The ability to excrete fats is im-
paired, and therefore the storage of fats increases, in-
cluding cholesterol and fat-soluble nutrients.

• The amount of water in the body, which decreases, re-
ducing the body’s ability to absorb water-soluble nutri-
ents. Also, there is less saliva and other lubricating fluids.

• Liver and kidney activities, which become less effi-
cient, thus affecting the elimination of wastes.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Average annual growth rate (in percent) of the elderly population: 1910-30 to 2030-50. (Graph by Dana Hansen.)

• The ease of digestion, which is decreased, resulting in a
reduction in stomach acid production.

• Muscle strength and coordination, which lessens, with
an accompanying loss of mobility, agility, and flexibility.

• Sexual hormones and sexual function, which both de-
cline.

• Sensations of taste and smell, which decrease.

• Cardiovascular and respiratory systems, with changes
leading to decreased oxygen and nutrients throughout
the body.

• Nervous system, which experiences changes that result
in less efficient nerve impulse transmission, reflexes that
are not as sharp, and diminished memory and learning.

• Bone strength and density, which decrease.

• Hormone levels, which gradually decline. The thyroid
and sexual hormones are particularly affected.

• Visual abilities, which decline. Age-related changes
may lead to diseases such as macular degeneration.

• A compromised ability to produce vitamin D from
sunlight.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Protein formation, which is reduced, leading to shrink-
age in muscle mass and decreased bone formation, pos-
sibly contributing to osteoporosis.

Causes & symptoms

There are several theories on why the aging body
loses functioning. It may be that several factors work to-
gether or that one particular factor is the culprit in a
given individual. These theories include:

• Programmed senescence, or aging clock, theory. The
aging of the cells for each individual is programmed
into the genes, and there is a preset number of possible
rejuvenations in the life of a given cell. When cells die
at a rate faster than they are replaced, organs do not
function properly, and they become unable to maintain
the functions necessary for life.

• Genetic theory. Human cells maintain their own seed of
destruction at the chromosome level.

• Connective tissue, or cross-linking theory. Changes in
the makeup of the connective tissue alter the stability of
body structures, causing a loss of elasticity and func-
tioning, and leading to symptoms of aging.

Aging

• Free -radical theory. The most commonly held theory of
aging, is based on the fact that ongoing chemical reac-
tions of the cells produce free radicals. In the presence
of oxygen, these free radicals cause the cells of the
body to break down. As time goes on, more cells die or
lose the ability to function, and the body ceases to
function as a whole.

• Immunological theory. There are changes in the im-
mune system as it begins to wear out, and the body is
more prone to infections and tissue damage, which
may ultimately cause death. Also, as the system breaks
down, the body is more apt to have autoimmune reac-
tions, in which the body’s own cells are mistaken for
foreign material and are destroyed or damaged by the
immune system.

Diagnosis

Many problems can arise due to age-related changes
in the body. Although there is no individual test to mea-
sure these changes, a thorough physical exam and a
basic blood screening and blood chemistry panel can
point to areas in need of further attention. When older
people become ill, the first signs of disease are often
nonspecific. Further exams should be conducted if any
of the following occur:

• diminished, or lack of, desire for food

• increased confusion

• failure to thrive

• urinary incontinence

• dizziness

• weight loss

• falling

Treatment

Nutritional supplements

Consumption of a high-quality multivitamin is rec-
ommended. Common nutritional deficiencies connected
with aging include B vitamins, vitamin A and vitamin
C, folic acid, calcium, magnesium, zinc, iron, chromi-
um, and trace minerals. Since stomach acids may be de-
creased, powdered multivitamin formula in gelatin cap-
sules are suggested, as this form is the easiest to digest.
Such formulas may also contain enzymes for further
help with digestion.

Antioxidants can help neutralize damage caused by
free radical actions, which are thought to contribute to
problems of aging. They are also helpful in preventing
and treating cancer, and in treating cataracts and glau-
coma. Supplements that serve as antioxidants include:

•Vitamin E, 400-1,000 IUs daily. Protects cell mem-
branes against damage. It shows promise in preventing
heart disease, and Alzheimer’s and Parkinson’s diseases.

• Selenium, 50 mg taken twice daily. Research suggests
that selenium may play a role in reducing cancer risk.

• Beta-carotene, 25,000-40,000 IUs daily. May help in
treating cancer, colds and flu, arthritis, and immune
support.

• Vitamin C, 1,000-2,000 mg per day. It may cause diar-
rhea in large doses. The dosage should be decreased if
this occurs.

Other supplements that are helpful in treating age-
related problems include:

• B l2 /B-complex vitamins. Studies show that B 12 may
help reduce mental symptoms, such as confusion,
memory loss, and depression.

• Coenzyme Q 10 may be helpful in treating heart disease.
Up to 75% of cardiac patients have been found to lack
this heart enzyme.

Hormones

The following hormone supplements may be taken
to prevent or treat various age-related problems. Howev-
er, caution should be taken before beginning treatment,
and the patient should consult his or her health care pro-
fessional prior to hormone use.

DHEA improves brain functioning and serves as a
building block for many other important hormones. It
may be helpful in restoring hormone levels that have de-
clined, building muscle mass, strengthening bones, and
maintaining a healthy heart.

Melatonin may be helpful for insomnia. It has also
been used to help fight viruses and bacterial infections,
reduce the risk of heart disease, improve sexual function,
and to protect against cancer.

Human growth hormone (hGH) has been shown to
regulate blood sugar levels and to stimulate bone, carti-
lage, and muscle growth while reducing fat.

Herbs

Garlic ( Allium sativa ) is helpful in preventing heart
disease, and improving the tone and texture of skin. Gar-
lic stimulates liver and digestive system functions, and
also helps manage heart disease and high blood pressure.

Siberian ginseng ( Eleutherococcus senticosus) sup-
ports the adrenal glands and immune functions. It is be-
lieved to be helpful in treating problems related to stress.
Siberian ginseng also increases mental and physical per-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

formance, and may be useful in treating memory loss,
chronic fatigue, and immune dysfunction.

Ginkgo biloba works particularly well on the brain
and nervous system, it is effective in reducing the symp-
toms of such conditions as Alzheimer’s disease, depres-
sion, visual disorders, and problems of blood circulation.
It may also help treat heart disease, strokes, dementia,
Raynaud’s disease, head injuries, leg cramps, macular
degeneration, tinnitus, impotence due to poor blood
flow, and diabetes-related nerve damage.

Proanthocyanidins, or PCO, (brand name Pycnogenol),
are derived from grape seeds and skin, as well as pine tree
bark. They may help prevent cancer and poor vision.

Green tea has powerful antioxidant qualities, and
has been used for centuries as a natural medicine in
China, Japan, and other Asian cultures. In alternative
medicine, it aids in treating cancer, rheumatoid arthri-
tis, high cholesterol, heart disease, infection, and im-
paired immune function. Several scientific studies have
shown that antioxidant benefits are obtained by drinking
two cups of green tea each day.

In Ayurvedic medicine, aging is described as a
process of increased vata, in which there is a tendency to
become thinner, drier, more nervous, more restless, and
more fearful, while experiencing declines in both sleep
and appetite. Bananas, almonds, avocados, and coconuts
are some of the foods used in correcting such conditions.
One of the main herbs used to treat these problems is
gotu kola ( Centella asiatica). It is taken to revitalize the
nervous system and brain cells, and to fortify the im-
mune system. Gotu kola is also used to treat memory
loss, anxiety, and insomnia.

In Chinese medicine, most symptoms of aging are
regarded as signs of a yin deficiency. Moistening foods
are recommended, and include barley soup, tofu, mung
beans, wheat germ, spirulina, potatoes, black sesame
seeds, walnuts, and flax seeds. Jing tonics may also be
used. These include deer antler, dodder seeds, processed
rehmannia, longevity soup, mussels, and chicken.

Allopathic treatment

For the most part, doctors prescribe medications to
control the symptoms and diseases of aging. In the Unit-
ed States, about two-thirds of people age 65 and over
take medications for various conditions. More women
than men use these medications. The most common
drugs used by the elderly are painkillers, diuretics or
water pills, sedatives, cardiac medications, antibiotics,
and mental health remedies.

Estrogen replacement therapy (ERT) is commonly
prescribed to alleviate the symptoms of aging in post-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

menopausal women. It is often used in conjunction with
progesterone. These drugs help keep bones strong, re-
duce the risk of heart disease, restore vaginal lubrication,
and improve skin elasticity. Evidence suggests that they
may also help maintain mental functions.

Expected results

Aging is unavoidable, but major physical impair-
ment is not. People can lead healthy, disability-free lives
throughout their later years. A well-established support
system of family, friends, and health care providers,
along with a focus on good nutrition and lifestyle
habits, and effective stress management, can prevent dis-
ease and lessen the impact of chronic conditions.

Prevention

Preventive health practices such as healthy diet,
daily exercise, stress management, and control of
lifestyle habits, such as smoking and drinking, can
lengthen the life span and improve the quality of life as
people age. Exercise can improve appetite, bone
health, emotional and mental outlook, digestion, and
circulation.

Drinking plenty of fluids aids in maintaining healthy
skin, good digestion, and proper elimination of wastes.
Up to eight glasses of water should be consumed daily,
along with plenty of herbal teas, diluted fruit and veg-
etable juices, and fresh fruits and vegetables that have a
high water content.

Because of a decrease in the sense of taste, older
people often increase their salt intake, which can con-
tribute to high blood pressure and nutrient loss. Use of
sugar is also increased. Seaweeds and small amounts of
honey can be used as replacements.

Alcohol, nicotine, and caffeine all have potential
damaging effects, and consumption should be limited or
completely eliminated.

A diet high in fiber and low in fat is recommended.
Processed foods should be replaced by such complex
carbohydrates as whole grains. If chewing becomes a
problem, there should be an increased intake of protein
drinks, freshly juiced fruits and vegetables, and
creamed cereals.

Resources

BOOKS

Cox, Harold. Aging. New York, NY: McGraw Hill College Di-
vision, 2004.

Giampapa, Vincent, et al. The Anti-Aging Solution: 5 Simple

Steps to Looking and Feeling Young. Hoboken, NJ: John

Wiley & Sons, 2004.

Aging

AIDS

KEY TERMS

Antioxidants — Substances that counteract the
damaging effects of oxidation in the body's tis-
sues.

Alzheimer's disease — A condition causing a de-
cline in brain function that interferes with the abil-
ity to reason and to perform daily activities.

Senescence — Aging.

Vata — One of the three main constitutional types
found under Ayurvedic principles. Keeping one's
particular constitution in balance is considered
important in maintaining health.

Panno, Joseph. Aging: Theories and Potential Therapies New
York, NY: Facts on File. Inc., 2004.

Landis, Robyn, with Karta Purkh Singh Khalsa. Herbal De-
fense: Positioning Yourself to Triumph Over Illness and
Aging New York, NY: Warner Books, 1997.

Weil, Andrew M.D. Healthy Aging New York, NY: Knopf,
2004.

PERIODICALS

“Chemopreventive Effects of Green Tea Said to Delay Aging of
Skin.” Cancer Weekly (April 13, 2004): 10.

“Discovery Claims to Link DNA Test to Reversing Signs of
Aging.” Drug Week (February 27, 2004): 122.

“Fitness Can Improve Thinking Among Aging.” Obesity, Fit-
ness & Wellness Week (March 13, 2004): 16.

“Hormonal Activity Plays Role in Body Composition Changes
with Aging.” Obesity, Fitness & Wellness Week (March 20,
2004): 3.

Lofshult, Diane. “Aging Trends for 2004.” IDEA Health & Fit-
ness Source (March 2004): 14.

“Research Reports on Key Antioxidant to Slow Aging.” Drug
Week (April 2, 2004): 194.

ORGANIZATIONS

The Anti- Aging Institute. 843 William Hilton Parkway. Hilton
Head, SC 29928. (912) 238-3383. <http://www.anti-aging.
org>.

The Rosenthal Center for Complementary and Alternative
Medicine Research in Aging and Women's Health. Co-
lumbia University, College of Physicians and Surgeons,
630 W. 168th St., New York, NY 10032. <http://www.
rosenthal.hs.columbia.edu>.

OTHER

National Institute on Aging Senior Health Web site. <http://
www.nihseniorhealth.gov>.

Patience Paradox
Ken Wells

AIDS

Definition

Acquired immune deficiency syndrome (AIDS) is
an infectious disease caused by the human immunodefi-
ciency virus (HIV). It was first recognized in the United
States in 1981. AIDS is the advanced form of infection
with the HIV virus, which may not cause disease for a
long period after the initial exposure (latency). Infection
with HIV weakens the immune system which makes in-
fected people susceptible to infection and cancer.

Description

AIDS is considered one of the most devastating pub-
lic health problems in recent history. In 1996, the Centers
for Disease Control and Prevention (CDC) estimated that
one million persons in the United States were HlV-posi-
tive, and 223,000 are living with AIDS. Of these patients,
44% were gay or bisexual men, 26% are heterosexual in-
travenous drug users, and 18% were women. In addition,
approximately 1 ,000-2,000 children are born each year
with HIV infection. In 2002, the CDC reported 42,136
new AIDS diagnoses in the United States, a 2.2% increase
from the previous year. AIDS cases rose among gay and
bisexual men (7.1% in 25 states that report regularly). The
disease also seems to be rising among older Americans.
From 1990 to 2001, the number of cases in Americans age
50 years or older rose from 16,288 to 90,153.

The World Health Organization (WHO) estimates
that 40 million people worldwide were infected with
AIDS/HIV as of 2001. Most of these cases are in the de-
veloping countries of Asia and Africa. In 2003, WHO
cautioned that if treatment were not delivered soon to
nearly 6 million people with AIDS in developing coun-
tries, there could be 45 million cases by 2010.

Risk factors

AIDS can be transmitted in several ways. The risk
factors for HIV transmission vary according to category:

• Sexual contact. Persons at greatest risk are those who
do not practice safe sex, are not monogamous, partici-
pate in anal intercourse, and have sex with a partner
with symptoms of advanced HIV infection and/or
other sexually transmitted diseases (STDs). In the
United States and Europe, most cases of sexually
transmitted HIV infection have resulted from homo-
sexual contact, whereas in Africa, the disease is
spread primarily through sexual intercourse among
heterosexuals.

• Transmission in pregnancy. High-risk mothers include
women married to bisexual men or men who have an ab-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Because the immune system cells are destroyed by the AIDS virus, many different types of infections and cancers can de-
velop, taking advantage of a person’s weakened immune system. (Illustration by Electronic Illustrators Group. The Gale Group.)

normal blood condition called hemophilia and require
blood transfusions, intravenous drug users, and women
living in neighborhoods with a high rate of HIV infection
among heterosexuals. The chances of transmitting the dis-
ease to the child are higher in women in advanced stages
of the disease. Breast feeding increases the risk of trans-
mission by 10-20% and is not recommended. The use of
zidovudine (AZT) during pregnancy and delivery, howev-
er, can decrease the risk of transmission to the baby.

• Exposure to contaminated blood or blood products.
With the introduction of blood product screening in the
mid-1980s, the incidence of HIV transmission in blood
transfusions has dropped to 1 in 100,000.

• Needle sticks among health care professionals. Present
studies indicate that the risk of HIV transmission by a
needle stick is about 1 in 250. This rate can be de-
creased if the injured worker is given AZT or triple
therapy (HAART), the current standard.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

HIV is not transmitted by handshakes or other casu-
al non-sexual contact, coughing or sneezing, or by
bloodsucking insects such as mosquitoes.

AIDS in women

AIDS in women is a serious public health concern.
Women exposed to HIV infection through heterosexual
contact are the most rapidly growing risk group in the
United States. The percentage of AIDS cases diagnosed
in women has risen from 7% in 1985 to 18% in 1996.
For unknown reasons, women with AIDS do not live as
long as men with AIDS.

AIDS in children

Because AIDS can be transmitted from an infected
mother to her child during pregnancy, during the birth
process, or through breast milk, all infants born to HIV-

AIDS

Kaposi’s sarcoma an AIDS-related cancer, usually appears
on the lower extremities, as evidenced on this patient’s hip.

(Custom Medical Stock Photo. Reproduced by permission.)

positive mothers are at risk. As of 1997, it was estimated
that 84% of HIV-positive women are of childbearing
age; 41% of them are drug abusers. Between 15-30% of
children born to HIV-positive women will be infected
with the virus.

AIDS is one of the 10 leading causes of death in
children between one and four years of age worldwide.
The interval between exposure to HIV and the develop-
ment of AIDS is shorter in children than in adults. In-
fants infected with HIV have a 20-30% chance of devel-
oping AIDS within a year and dying before age three. In
the remainder, AIDS progresses more slowly; the aver-
age child patient survives to seven years of age. Some
survive into early adolescence.

Causes & symptoms

Because HIV destroys immune system cells, AIDS
is a disease that can affect any of the body’s major organ
systems. HIV attacks the body through three disease
processes: immunodeficiency, autoimmunity, and ner-
vous system dysfunction.

Immunodeficiency describes the condition in which
the body’s immune response is damaged, weakened, or
is not functioning properly. In AIDS, immunodeficiency
results from the way that the virus binds to a protein
called CD4, which is found on certain white blood cells,
including helper T cells, macrophages, and monocytes.
Once HIV attaches to an immune system cell, it can
replicate within the cell and kill the cell. In addition to
killing some lymphocytes directly, the AIDS virus dis-
rupts the functioning of other CD4 cells. Because the im-
mune system cells are destroyed, infections and cancers
that take advantage of a person’s weakened immune sys-
tem (opportunistic) can develop.

Autoimmunity is a condition in which the body’s
immune system produces antibodies that work against its
own cells. Antibodies are specific proteins produced in
response to exposure to a specific, usually foreign, pro-
tein or particle called an antigen. In this case, the body
produces antibodies that bind to blood platelets that are
necessary for proper blood clotting and tissue repair.
Once bound, the antibodies mark the platelets for re-
moval from the body, and they are filtered out by the
spleen. Some AIDS patients develop a disorder, called
immune-related thrombocytopenia purpura (ITP), in
which the number of blood platelets drops to abnormally
low levels.

The course of AIDS generally progresses through
three stages, although not all patients will follow this
progression precisely:

Acute retroviral syndrome

Acute retroviral syndrome is a term used to describe
a group of symptoms that can resemble mononucleosis
and that may be the first sign of HIV infection in 50-
70% of all patients and 45-90% of women. The symp-
toms may include fever, fatigue, muscle aches, loss of
appetite, digestive disturbances, weight loss, skin
rashes, headache, and chronically swollen lymph nodes
(lymphadenopathy). Approximately 25-33% of patients
will experience a form of meningitis during this phase,
in which the membranes that cover the brain and spinal
cord become inflamed. Acute retroviral syndrome devel-
ops between one and six weeks after infection and lasts
two to four weeks, sometimes up to six weeks. Blood
tests during this period will indicate the presence of virus
(viremia) and the appearance of the viral p24 antigen in
the blood.

Latency period

After the HIV virus enters a patient’s lymph nodes
during the acute retroviral syndrome stage, the disease
becomes latent for as many as 10 years or more before
symptoms of advanced disease develop. During latency,
the virus continues to replicate in the lymph nodes, where
it may cause one or more of the following conditions.

PERSISTENT GENERALIZED LYMPHADENOPATHY

(PGL). Persistent generalized lymphadenopathy, or PGL,
is a condition in which HIV continues to produce chronic
painless swellings in the lymph nodes during the latency
period. The lymph nodes most frequently affected by PGL
are those in the areas of the neck, jaw, groin, and armpits.
PGL affects between 50-70% of patients during latency.

CONSTITUTIONAL SYMPTOMS. Many patients will
develop low-grade fevers, chronic fatigue, and general
weakness. HIV also may cause a combination of food

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

malabsorption, loss of appetite, and increased metabo-
lism that contribute to the so-called AIDS wasting or
wasting syndrome.

OTHER ORGAN SYSTEMS. At any time during the
course of HIV infection, patients may suffer from a
yeast infection in the mouth called thrush, open sores or
ulcers, or other infections of the mouth; diarrhea and
other gastrointestinal symptoms that cause malnutrition
and weight loss; diseases of the lungs and kidneys; and
degeneration of the nerve fibers in the arms and legs.
HIV infection of the nervous system leads to general loss
of strength, loss of reflexes, and feelings of numbness or
burning sensations in the feet or lower legs.

La t e-stage AIDS

Late-stage AIDS usually is marked by a sharp de-
cline in the number of CD4+ lymphocytes (a type of
white blood cell), followed by a rise in the frequency of
opportunistic infections and cancers. Doctors monitor
the number and proportion of CD4+ lymphocytes in the
patient’s blood in order to assess the progression of the
disease and the effectiveness of different medications.
About 10% of infected individuals never progress to this
overt stage of the disease.

OPPORTUNISTIC INFECTIONS. Once the patient’s
CD4+ lymphocyte count falls below 200 cells/mm 3 , he
or she is at risk for opportunistic infections. The infec-
tious organisms may include:

• Fungi. Fungal infections include a yeast infection of
the mouth (candidiasis or thrush) and cryptococcal
meningitis.

• Protozoa. The most common parasitic disease associat-
ed with AIDS is Pneumocystis carinii pneumonia
(PCP). About 70-80% of AIDS patients will have at
least one episode of PCP prior to death. PCP is the im-
mediate cause of death in 15-20% of AIDS patients. It
is an important measure of a patient’s prognosis. Toxo-
plasmosis is another common infection in AIDS pa-
tients that is caused by a protozoan. Other diseases in
this category include amebiasis and cryptosporidiosis.

• Mycobacteria. AIDS patients may develop tuberculo-
sis or MAC infections. MAC infections are caused by
Mycobacterium avium-intracellulare, and occur in
about 40% of AIDS patients.

• Bacteria. AIDS patients are likely to develop bacterial
infections of the skin and digestive tract.

• Viruses. AIDS patients are highly vulnerable to cy-
tomegalovirus (CMV), herpes simplex virus (HSV),
varicella zoster virus (VZV), and Epstein-Barr virus
(EBV) infections. Another virus, JC virus, causes pro-
gressive destruction of brain tissue in the brain stem,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ESTIMATED NUMBER OF ADULTS AND
CHILDREN LIVING WITH AIDS/HIV
WORLDWIDE AS OF 2001

Regions

Estimate

Australia & New Zealand

15,000

Caribbean

420,000

East Asia & Pacific

1,000,000

Eastern Europe & Central Asia

1,000,000

Latin America

1,500,000

North Africa & Middle East

500,000

North America

950,000

South & Southeast Asia

5,600,000

Sub-Saharan African

28,500,000

Western Europe

550,000

Global total

40,000,000+

cerebrum, and cerebellum (multifocal leukoen-
cephalopathy or PML), which is regarded as an AIDS-
defining illness by the Centers for Disease Control and
Prevention.

AIDS DEMENTIA COMPLEX AND NEUROLOGIC COM-
PLICATIONS. AIDS dementia complex is a late complica-
tion of the disease. It is unclear whether it is caused by the
direct effects of the virus on the brain or by intermediate
causes. AIDS dementia complex is marked by loss of rea-
soning ability, loss of memory, inability to concentrate,
apathy and loss of initiative, and unsteadiness or weakness
in walking. Some patients also develop seizures.

MUSCULOSKELETAL COMPLICATIONS. Patients in
late-stage AIDS may develop inflammations of the mus-
cles, particularly in the hip area, and may have arthritis-
like pains in the joints.

ORAL SYMPTOMS. Patients may develop a condition
called hairy leukoplakia of the tongue. This condition
also is regarded by the CDC as an indicator of AIDS.
Hairy leukoplakia is a white area of diseased tissue on
the tongue that may be flat or slightly raised. It is caused
by the Epstein-Barr virus.

AIDS-RELATED CANCERS. Patients with late-stage
AIDS may develop Kaposi’s sarcoma (KS), a skin tumor
that primarily affects homosexual men. KS is the most
common AIDS -related malignancy. It is characterized by
reddish-purple blotches or patches (brownish in African-
Americans) on the skin or in the mouth. About 40% of

AIDS

patients with KS develop symptoms in the digestive tract
or lungs. KS appears to be caused by a herpes virus.

The second most common form of cancer in AIDS
patients is a tumor of the lymphatic system (lymphoma).
AIDS -related lymphomas often affect the central ner-
vous system and develop very aggressively.

Invasive cancer of the cervix is an important diag-
nostic marker of AIDS in women.

Diagnosis

Because HIV infection produces such a wide range
of symptoms, the CDC has drawn up a list of 34 condi-
tions regarded as defining AIDS. The physician will use
the CDC list to decide whether the patient falls into one
of these three groups:

• definitive diagnoses with or without laboratory evi-
dence of HIV infection

• definitive diagnoses with laboratory evidence of HIV
infection

• presumptive diagnoses with laboratory evidence of
HIV infection

Physical findings

Almost all symptoms of AIDS can occur with other
diseases. The general physical examination may range
from normal findings to symptoms that are closely asso-
ciated with AIDS. These symptoms are hairy leukoplakia
of the tongue and Kaposi’s sarcoma. When the doctor
examines the patient, he or she will look for the overall
pattern of symptoms rather than any one finding.

Laboratory tests for HIV infection

BLOOD TESTS (SEROLOGY). The first blood test for
AIDS was developed in 1985. At present, patients who
are being tested for HIV infection usually are given an
enzyme-linked immunosorbent assay (ELISA) test for
the presence of HIV antibody in their blood. Positive
ELISA results then are tested with a Western blot or im-
munofluorescence (1FA) assay for confirmation. The
combination of the ELISA and Western blot tests is more
than 99.9% accurate in detecting HIV infection within
four to eight weeks following exposure. The polymerase
chain reaction (PCR) test can be used to detect the pres-
ence of viral nucleic acids in the very small number of
HIV patients who have false-negative results on the
ELISA and Western blot tests. In 2003, a one-step test
that was quicker and cheaper was shown effective for de-
tecting HIV in the physician office setting. However, fur-
ther research was ongoing as to its effectiveness in re-
placing current tests as a first check for HIV.

OTHER LABORATORY TESTS. In addition to diagnos-
tic blood tests, there are other blood tests that are used to
track the course of AIDS. These include blood counts,
viral load tests, p24 antigen assays, and measurements of
(3 2 -microglobulin ((3 2 M).

Doctors will use a wide variety of tests to diagnose
the presence of opportunistic infections, cancers, or
other disease conditions in AIDS patients. Tissue biop-
sies, samples of cerebrospinal fluid, and sophisticated
imaging techniques, such as magnetic resonance imag-
ing (MRI) and computed tomography scans (CT) are
used to diagnose AIDS-related cancers, some oppor-
tunistic infections, damage to the central nervous sys-
tem, and wasting of the muscles. Urine and stool sam-
ples are used to diagnose infections caused by parasites.
AIDS patients also are given blood tests for syphilis and
other sexually transmitted diseases.

Diagnosis in children

Diagnostic blood testing in children older than 18
months is similar to adult testing, with ELISA screening
confirmed by Western blot. Younger infants can be diag-
nosed by direct culture of the HIV virus, PCR testing,
and p24 antigen testing.

In terms of symptoms, children are less likely than
adults to have an early acute syndrome. They are, how-
ever, likely to have delayed growth, a history of frequent
illness, recurrent ear infections, a low blood cell count,
failure to gain weight, and unexplained fevers. Children
with AIDS are more likely to develop bacterial infec-
tions, inflammation of the lungs, and AIDS-related brain
disorders than are HIV-positive adults.

Treatment

AIDS patients turn to alternative medicine when
conventional treatments are ineffective, and to supple-
ment conventional treatment, reduce disease symptoms,
counteract drug effects, and improve quality of life. Be-
cause alternative medicines may interact with conven-
tional medicines, it is important for the patient to inform
his or her doctor of all treatments being used.

A report released in 2003 showed trends in in-
creased use of alternative medicine among HIV-positive
individuals. Based on 1997 figures, the study reported
that 79% of those seeking alternative therapy to help
with AIDS treatment or symptom relief were men and
63% were women. The types of therapies they used most
were relaxation techniques, massage, chiropractic care,
self-help groups, commercial diets, and acupuncture.

Supplements

• Laurie oils (coconut oil) are used by the body to make
monolaurin, which inactivates HIV.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Selenium deficiency increases the risk of death due to
AIDS-related illness. One study found that 250 micro-
grams of selenomethionin daily for one year showed no
improvement in CD4 cell counts or disease symptoms.
Greater than 1,000 micrograms daily is toxic.

• Vitamin C has antioxidant and antiretroviral activities.
One study found that treatment caused a trend to de-
crease viral load.

• DHEA (dehydroepiandrosterone) is commonly used by
AIDS patients to counteract wasting. One study found
that DHEA had no effect on lymphocytes or p24 anti-
gen levels. However, a 2002 study found that it was as-
sociated with a significant increase in measures that in-
dicate mental health improvement.

• Vitamin A deficiency is associated with increased mor-
tality. One study of pregnant women with AIDS found
that 5000 IU of vitamin A daily led to stabilized viral
load as compared to a placebo group. Another study
found that 60 mg of vitamin A had no effect on CD4
cells or viral load. Vitamin A has been associated with
faster disease progression. Excessive vitamin A during
pregnancy can cause birth defects.

• Beta-carotene supplementation for AIDS is controver-
sial as studies have shown both beneficial and detri-
mental effects. Beta-carotene supplementation has led
to elevation in white blood cell counts and changes in
the CD4 cell count. Some studies have found that beta-
carotene supplementation led to an increase in deaths
due to cancer and heart disease.

Naturopathic doctors often recommend the follow-
ing supplements for AIDS:

• beta-carotene, 150,000 IU daily

• vitamin C, 2,000 mg thrice daily

• vitamin E, 400 IU twice daily

• cod liver oil, 1 tablespoon daily

• multivitamin, as directed

• coenzyme Q 10 , 50-60 mg twice daily

Herbals and Chinese medicine

One small study of the effectiveness of Chinese
herbal treatment in AIDS showed promise. AIDS pa-
tients took a tablet that contained 31 herbs that was
based on the formulas Enhance and Clear Heat. Disease
symptoms were reduced in the herbal treatment group as
compared to the placebo group.

Herbals used in treating AIDS include:

• Maitake mushroom extract. Recommended dose is 10
drops twice daily

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Licorice ( Glycyrrhiza glabra ) solid extract. Recom-
mended dose is one quarter to one half teaspoon twice
daily

• Boxwood extract (SPV-30) has antiviral activity. Rec-
ommended dose is one capsule thrice daily.

• Garlic concentrate (Allicin) helped reduce bowel
movements, stabilized or increased body weight, or
cured Cryptosporidium parvum infection in affected
AIDS patients. However, a 2002 National Institutes of
Health study cautioned that garlic supplements could
reduce levels of a protease inhibitor that is used to treat
AIDS patients, so patients should discuss using garlic
supplements with their physicians.

• Tea tree oil ( Malaleuca ) improves or cures infection of
the mouth by the yeast Candida. Tea tree oil is avail-
able as soap, dental floss, toothpick, and mouthwash.

• Marijuana is used to treat wasting. Studies have found
that patients who use marijuana had increased food in-
take and weight gain. The active ingredient delta-9-
tetrahydrocannabinol is licensed for treating AIDS
wasting.

Psychotherapy and stress reduction

Many therapies that are directed at improving men-
tal state can have a direct impact on disease severity and
quality of life. The effectiveness of many have been
proven in clinical studies. These include:

• massage

• laughter/humor

• stress management training

• visualization

• cognitive therapy

• aerobic exercise

• prayer

Other treatments for AIDS include homeopathy,
naturopathy, acupuncture, and chiropractic.

Allopathic treatment

Treatment for AIDS covers four categories:

Antiretroviral treatment

In recent years researchers have developed drugs
that suppress HIV replication. The drugs are used in
combination with one another and fall into four classes:

• Nucleoside reverse transcriptase inhibitors. These drugs
work by interfering with the action of HIV reverse tran-
scriptase, thus ending the virus replication process.
These drugs include zidovudine (sometimes called Zi-

AIDS

dovudine or AZT, trade name Retrovir), didanosine
(ddi, Videx), emtricitabine (FTC, Emtriva), zalcitabine
(ddC, Hivid), stavudine (d4T, Zerit), abacavir (Ziagen),
tenofovir (df, Viread), and lamivudine (3TC, Epivir).

• Protease inhibitors. Protease inhibitors are effective
against HIV strains that have developed resistance to
nucleoside analogues, and often are used in combina-
tion with them. These compounds include saquinavir
(Fortovase), ritonavir (Norvir), indinavir (Crixivan),
amprenavir (Agenerase), lopinavir plus ritonavir (Rey-
ataz), and nelfinavir (Viracept).

• Non-nucleoside reverse transcriptase inhibitors. This is
a newer class of antiretroviral agents. Three are avail-
able, nevirapine (Viramune), efavirenz (Sustiva), and
delavirdine (Rescript or).

• Fusion inhibitors. These drugs are less common, ex-
pensive and difficult to use. They block infection early
by preventing HIV from fusing with and entering a
human cell. This class includes only one compound:
Enfuvirtide (Fuzeon).

Treatment guidelines for these agents are in constant
change as new medications are developed and intro-
duced. In mid-2003, the U.S. Department of Health and
Human Services revised its guidelines for the use of
these agents to help clinicians better choose the best
combinations. The new guidelines offer a list of suggest-
ed combination regimens classified as either “preferred”
or “alternative”.

Treatment of opportunistic infections

and malignancies

Most AIDS patients require complex long-term
treatment with medications for infectious diseases. This
treatment often is complicated by the development of re-
sistance in the disease organisms. AIDS-related malig-
nancies in the central nervous system usually are treated
with radiation therapy. Cancers elsewhere in the body
are treated with chemotherapy.

Prophylactic treatment for opportunistic infections

Prophylactic treatment is treatment that is given to
prevent disease. AIDS patients with a history of Pneu-
mocystis pneumonia; with CD4+ counts below 200
cells/mm 3 or 14% of lymphocytes; weight loss; or thrush
should be given prophylactic medications. The three
drugs given are trimethoprim-sulfamethoxazole, dap-
sone, or pentamidine in aerosol form.

STIMULATION OF BLOOD CELL PRODUCTION. Be-
cause many patients with AIDS suffer from abnormally
low levels of both red and white blood cells, they may be
given medications to stimulate blood cell production.

Epoetin alfa (erythropoietin) may be given to anemic pa-
tients. Patients with low white blood cell counts may be
given filgrastim or sargramostim.

Treatment in women

Treatment of pregnant women with HIV is particu-
larly important because antiretroviral therapy has been
shown to reduce transmission to the infant by 65%.

Expected results

At the present time, there is no cure for AIDS. Treat-
ment stresses aggressive combination drug therapy when
possible. The use of multi-drug therapies has significant-
ly reduced the number of U.S. deaths resulting from
AIDS. The potential exists to possibly prolong life indef-
initely using these and other drug therapies to boost the
immune system, keep the virus from replicating, and
ward off opportunistic infections and malignancies.

Prognosis after the latency period depends on the
patient’s specific symptoms and the organ systems af-
fected by the disease. Patients with AIDS-related lym-
phomas of the central nervous system die within two to
three months of diagnosis; those with systemic lym-
phomas may survive for eight to ten months. In America,
the successful treatment of AIDS patients with HAART
has actually led to a growing number of people living
with HIV. About 25,000 infected people per year are
added to the list of HIV-infected Americans.

However, not only does HAART and other treat-
ment prolong AIDS patients’ lives, it has led to some im-
provement in quality of life too. A recent study shows
that HAART therapy substantially reduces risk of AIDS-
related pneumonia (PCP), although PCP still remains the
most common AIDS-defining illness among opportunis-
tic infections. Other recent studies show that these pro-
tease inhibitors may result in high cholesterol and put
AIDS patients at eventual risk for heart disease. Further
research must be done, since long-term effects of
HAART treatment are just now being studied. Most clin-
icians would say the benefits outweigh the risks anyway.

Prevention

As of 2000, there is no vaccine effective against
AIDS. Several vaccines to prevent initial HIV infection
and disease progression are being tested. In 2002, reports
showed a new “library” vaccine showed potential. The
vaccine is composed of up to 32 HIV gene fragments
that can induce a number of immune responses. In the
same year, the British government worked with five
African countries in a trial to find an effective gel that
would protect women against HIV during sex. The study

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

leaders believed if they could find a lotion that could be
applied before intercourse that would help prevent HIV
transmission, they would give women the ability to bet-
ter protect themselves from HIV. In 2003, the first
human test of a vaccine against the most common sub-
type of HIV was underway.

Precautions to take to prevent the spread of AIDS
include:

• Monogamy and practicing safe sex. Besides avoiding
the risk of HIV infection, condoms are successful in
preventing other sexually transmitted diseases and un-
wanted pregnancies.

• Avoiding needle sharing among intravenous drug users.

• Although blood and blood products are carefully moni-
tored, those individuals who are planning to undergo
major surgery may wish to donate blood ahead of time
to prevent a risk of infection from a blood transfusion.

• Healthcare professionals should wear gloves and masks
when handling body fluids and avoid needle-stick in-
juries.

• A person who suspects that he or she may have become
infected should get tested. If treated aggressively and
early, the development of AIDS can sometimes be post-
poned indefinitely. If HIV infection is confirmed, it
also is vital to inform sexual partners.

Resources

BOOKS

Abrams, Donald I. "Alternative Therapies.” AIDS Therapy.
edited by Raphael Dolin et al. Philadelphia: Churchill
Livingstone, 1999.

Early HIV Infection Guideline Panel. Evaluation and Manage-
ment of Early HIV Infection. Rockville, MD: U.S. Depart-
ment of Health and Human Services, Agency for Health
Care Policy and Research, 1994.

The Global AIDS Policy Coalition. AIDS in the World. Cam-
bridge, MA: Harvard University Press, 1992.

Huber, Jeffrey T. Dictionary of AIDS-Related Terminology.
New York and London: Neal-Schuman Publishers, Inc.,
1993.

"Infectious Diseases: Human Immunodeficiency Virus (HIV).”
In Neonatology: Management, Procedures, On-Call Prob-
lems, Diseases and Drugs, edited by Tricia Lacy Gomella,
et al. Norwalk, CT: Appleton & Lange, 1994.

Katz, Mitchell H. and Harry Hollander. "HIV Infection.” In
Current Medical Diagnosis & Treatment 1998. edited by
Lawrence M. Tierney Jr., et al. Stamford, CT: Appleton &
Lange, 1998.

McCutchan, J. Allen. "Alternative, Unconventional, and Un-
proven Therapies.” Textbook of AIDS Medicine, 2nd edi-
tion. edited by Thomas C. Merigan, et al. Baltimore:
Williams & Wilkins, 1999.

McFarland, Elizabeth J. “Human Immunodeficiency Virus
(HIV) Infections: Acquired Immunodeficiency Syndrome

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

(AIDS).” In Current Pediatric Diagnosis & Treatment.
edited by William W. Hay Jr., et al. Stamford, CT: Apple-
ton & Lange, 1997.

So, Peter and Livette Johnson. "Acquired Immune Deficiency
Syndrome (AIDS).” In Conn's Current Therapy, edited by
Robert E. Rakel. Philadelphia: W. B. Saunders Company,
1997.

Standish, Leanna J., Roberta C.M. Wines, and Cherie Reeves.
“Complementary/Alternative Therapies in Select Popula-
tions: Women with HIV and AIDS.” In Complementary /
Alternative Medicine: An Evidence Based Approach, edit-
ed by John W. Spencer and Joseph J. Jacobs. St. Louis:
Mosby, 1999.

PERIODICALS

“DHEA in HIV Infection.” Infectious Disease Alert. (March 1 .

2002) : S7.

Ernst, Jerome. “Alternative Treatment Modalities in Human
Immunodeficiency Virus/Acquired Immune Deficiency
Syndrome.” Clinical Infectious Diseases (September 1,

2003) : 150-154.

"First Human Tests Under Way of HIV Vaccine Pioneered at
UNC.” AIDS Vaccine Week (August 25, 2003): 2.

Fleck, Fiona. "British Medical Journal.” British Medical Jour-
nal (September 27, 2003): 698.

Gangel, Elaine K. "Garlic Supplements and HIV Medication.”
American Family Physician (March 15, 2002): 1225.

“Government Lauches Trial of Gel to Protect Women Against
HIV.” AIDS Weekly (March 25, 2002): 11.

"HIV Drugs Approved as of August 2003.” AIDS Treatment
News (July 25, 2003): 4.

"HIV Rising Among Gay, Bisexual Men.” Medical Letter on
the CDC & FDA (August 24, 2003): 9.

"Is HAART Hard on the Heart” Science News (March 9, 2002):
158.

"Library Vaccine Shows Promise.” Vaccine Weekly. (February
13, 2002): 2.

"One-step HIV Test May Be Cheaper. Faster, Less Wasteful.”
AIDS Weekly (September 29, 2003): 13.

Ozsoy, Metin and Edzard Ernst. "How Effective are Comple-
mentary Therapies for HIV and AIDS? — a Systematic Re-
view.” International Journal of STD & AIDS 10 (1999):
629- 635.

"Prevalence of HIV Infection Increasing in Older Americans.”
AIDS Weekly (September 1, 2003): 16.

"Revised Guidelines Will Ease Selection of HIV/AIDS Treat-
ments.” Drug Week (August 8, 2003): 10.

“Successful HAART Reduces Risk of Pneumonia.” AIDS
Weekly (January 14, 2002): 24.

“Success of Treatment Swells Ranks of HIV Infected.” AIDS
Weekly (March 25, 2002): 13.

Wootton, Jacqueline C. “Web Watch: Alternative and Comple-
mentary Therapies.” AIDS Patient Care and STDs 12
(1998): 811-813.

ORGANIZATIONS

American Foundation for AIDS Research, 733 Third Avenue,
12th floor, 1515 Broadway, Suite 3601, New York, NY
10017. (212) 682- 7440.

AIDS

KEY TERMS

Acute retroviral syndrome — A group of symptoms
resembling mononucleosis that often are the first
sign of HIV infection.

AIDS dementia complex — A type of brain dysfunction
caused by HIV infection that causes difficulty thinking,
confusion, and loss of muscular coordination.

Antibody — A specific protein produced by the im-
mune system in response to a specific foreign pro-
tein or particle called an antigen.

Antigen — Any substance that stimulates the body
to produce antibody.

Autoimmunity — A condition in which the body's
immune system produces antibodies in response to
its own tissues or blood components instead of to
foreign particles or microorganisms.

CD4 — A type of protein molecule in human blood.
The HIV virus infects cells with CD4 surface pro-
teins, and as a result, depletes the number of T
cells, B cells, natural killer cells, and monocytes in
the patient's blood.

Hairy leukoplakia of the tongue — A white area of
diseased tissue on the tongue that may be flat or
slightly raised. It is caused by the Epstein-Barr virus
and is an important diagnostic sign of AIDS.

Hemophilia — Hereditary blood clotting disorders
occurring almost exclusively in males.

Human immunodeficiency virus (HIV) — A trans-
missible retrovirus that causes AIDS in humans. Two
forms of HIV are now recognized: HIV-1, which
causes most cases of AIDS in Europe, North and
South America, and most parts of Africa; and HIV-2,
which is chiefly found in West African patients.

Immunodeficient — A condition in which the
body's immune response is damaged, weakened,
or is not functioning properly.

Kaposi's sarcoma — A cancer of the connective tis-
sue that produces painless purplish red (in people
with light skin) or brown (in people with dark skin)
blotches on the skin. It is a major diagnostic mark-
er of AIDS.

Latent period — Also called incubation period, the
time between infection with a disease-causing
agent and the development of disease.

Lymphocyte — A type of white blood cell that is im-
portant in the formation of antibodies and that can
be used to monitor the health of AIDS patients.

Lymphoma — A cancerous tumor in the lymphatic
system that is associated with a poor prognosis in
AIDS patients.

Macrophage — A large white blood cell, found pri-
marily in the bloodstream and connective tissue,
that helps the body fight off infections by ingesting
the disease-causing organism.

Monocyte — A large white blood cell that is formed
in the bone marrow and spleen.

Mycobacterium avium (MAC) infection — A type
of opportunistic infection that occurs in about 40%
of AIDS patients and is regarded as an AIDS-defin-
ing disease.

Opportunistic infection — An infection by organ-
isms that usually don't cause infection in people
whose immune systems are working normally.

Persistent generalized lymphadenopathy (PGL) —

A condition in which HIV continues to produce
chronic painless swellings in the lymph nodes dur-
ing the latency period.

Pneumocystis carinii pneumonia (PCP) — An op-
portunistic infection caused by a fungus that is a
major cause of death in patients with late-stage
AIDS.

Progressive multifocal leukoencephalopathy
(PML) — A d isease caused by a virus that destroys
white matter in localized areas of the brain. It is re-
garded as an AIDS-defining illness.

Protozoan — A single-celled, usually microscopic
organism that has a nucleus and is, therefore differ-
ent from bacteria.

Retrovirus — A virus that contains a unique enzyme
called reverse transcriptase that allows it to repli-
cate within new host cells.

T cells — Lymphocytes that originate in the thymus
gland. CD4 lymphocytes are a subset of T lympho-
cytes.

Thrush — A yeast infection of the mouth character-
ized by white patches on the inside of the mouth
and cheeks.

Viremia — The measurable presence of virus in the
bloodstream that is a characteristic of acute retro-
viral syndrome.

Wasting syndrome — A progressive loss of weight
and muscle tissue caused by the AIDS virus.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Gay Men's Health Crisis, Inc., 129 West 20th Street, New
York, NY 10011-0022. (212) 807-6655.

National AIDS Hot Line. (800) 342-AIDS (English). (800) 344-
SIDA (Spanish). (800) AIDS-TTY (hearing-impaired).

Belinda Rowland
Teresa G. Odle

Alcoholism

Definition

Alcoholism is the layman’s term for alcohol depen-
dence and alcohol abuse. According to the Diagnostic and
Statistical Manual of Mental Disorders, published by the
American Psychiatric Association and commonly called the
DSM-IV, the essential feature of substance abuse (in this in-
stance, alcohol abuse) is maladaptive use of the substance
with recurrent and significant adverse consequences related
to its repeated use. Dependence is a physical addiction with
psychological, social and genetic components. Despite
damage to health, finances, reputations, and relationships,
the alcohol dependent person will continue to drink unless
an intervention occurs. Abuse, distinguished from depen-
dence by retaining some control over the use of alcohol,
nevertheless carries many of the same consequences over
time, and certainly increases risk of dependence.

Today, alcohol abuse and alcohol dependence are
often associated with abuse of, or dependence on, other
substances including nicotine, marijuana, cocaine,
heroin, amphetamines, sedatives, and anxiolytics (anti-
anxiety drugs). Alcoholism is more common in males
than in females, with an estimated male-to-female ratio
as high as five-to-one. A United States study conducted
between 1990 and 1991, using DSM standards, found
that 14% of the adult population (ages 15-54) had, at
some time, met the criteria for alcohol dependence; and
7% had been alcohol-dependent in the past year. An ear-
lier, similar study showed that about 5% of Americans
qualified for a diagnosis of alcohol abuse at some point
during their life. According to a 2002 report by the Na-
tional Council on Alcoholism and Drug Dependence, 14
million Americans abuse alcohol, and 100,000 die annu-
ally of alcohol related preventable causes. Though it is
difficult to develop accurate statistics worldwide, it is
known that the incidence of what we call alcoholism has
been steadily rising around the globe for several years.

Description

The effects of alcoholism are quite far-reaching. Al-
coholism affects every body system, causing a wide

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

range of drinking related health problems, including
lower testosterone, shrinking gonads, erectile dysfunc-
tion, interference with reproductive fertility, weak bones,
memory disorders, difficulty with balance and walking,
liver disease (including cirrhosis and hepatitis), high
blood pressure, weakness of muscles (including the
heart), disturbances of heart rhythm, anemia, clotting
disorders, weak immunity to infections, inflammation
and irritation of the entire gastrointestinal system, acute
and chronic problems with the pancreas, low blood
sugar, high blood fat content, and poor nutrition.

Its mental health implications include marital and
other relationship difficulties, depression, unemploy-
ment, poor performance at school or work, spouse and
child abuse, and general family dysfunction. Alcoholism
causes or contributes to a variety of severe social prob-
lems: homelessness, murder, suicide, injury, and violent
crime. Alcohol is a contributing factor in 50% of all
deaths from motor vehicle accidents. In fact, 50% of the
100,000 deaths that occur each year due to the effects of
alcohol are due to injuries of some sort. Alcohol costs
the United States over $150 billion yearly in lost produc-
tivity and alcohol related medical expense.

Causes & symptoms

A physical dependence on alcohol develops insidi-
ously, over time. The body is a magnificent adaptor;
therefore, with persistent use, many adaptations occur
physically and psychologically, resulting in both a higher
tolerance to and increased need for alcohol — craving it —
The physical adaptation to alcohol involves changing lev-
els and altered balances of neuro transmitters, chemicals
in the brain which not only affect physical abilities like
muscle coordination, but also mood. The abuse of alcohol
is associated with a desire to feel better and to avoid feel-
ing poorly. Initially a stimulant, it eventually acts as a
central nervous system (CNS) depressant and is used in a
majority of societies or cultures in the world as an accept-
ed part of dealing with life events, except where religious
opposition bans, discourages or prohibits its use, as in
most Muslim communities. It is included in celebrations
and, ironically, its use is perceived as an appropriate re-
sponse to sadness and loss, such as at wakes.

There is, at this point, no single known factor that
causes some people to be alcohol-dependent and others
not. Recent genetic studies have demonstrated that close
biological relatives of an alcoholic are four times more
likely to become alcoholics themselves. Furthermore,
this risk holds true even for children who were adopted
away from their biological families at birth and raised in
non-alcoholic homes, without knowledge of their biolog-
ical family’s difficulties with alcohol. Male gender,

Alcoholism

BAC (%)

Effects

0.02-0.03

Mood elevation; slight muscle relaxation

0.05-0.06

Relaxation and warmth; increased reaction time; decreased fine muscle coordination

0.08-0.09

Impaired balance, speech, vision, hearing, and muscle coordination; euphoria

0.14-0.15

Gross impairment of physical and mental control

0.20-0.30

Severely intoxicated; very little control of mind or body

0.40-0.50

Unconscious; deep coma; death from respiratory depression

being the child of an alcoholic parent or parents, extend-
ed family history and being of Irish (Celtic), Scandina-
vian, German, Polish, Russian or Native American an-
cestry, beginning drinking as a teenager, and being de-
pressed or highly anxious all increase the risk of experi-
encing problems with alcohol. Further research may
determine if genetic factors are accountable, in part, for
differences in alcohol metabolism and increase the risk
of an individual becoming an alcoholic. Other cause re-
lated factors in alcoholism include high levels of stress
and turmoil or pain, having drinking friends, drinking
partners, and “enablers” — people who facilitate a
drinkers habits and denial mechanisms. Heavy advertis-
ing that makes drinking appear to be “sexy” or the basis
of a good time also contributes. Consider, for example,
the number of televised sporting events that are spon-
sored heavily by alcohol related enterprises.

One of the classic symptoms of alcoholism is denial
of a problem with alcohol. An addicted person, under the
influence of the addictive substance, is physically and
psychologically motivated to perpetuate the addiction.
Therefore, intervention often starts when loved ones,
recognizing the signs and symptoms, bring attention to
the problem and call for help. Occasionally, an interven-
tion requires a whole family unit and outside assistance.
Signs and symptoms of alcohol dependence and abuse
may include the following:

• not remembering conversations or commitments

• losing interest in activities that were once pleasurable

• ritualized drinking, before, with, and after dinner and
being upset if the pattern is interrupted

• becoming irritable as “happy hour” approaches, espe-
cially if alcohol is not available

• drinking alone or secretly

• hiding alcohol in unusual places

• ordering doubles, drinking quickly, and drinking to be-
come drunk, intentionally

• focusing attention on the source of one’s next drink

• unstable relationships, financial, legal, and employ-
ment difficulties

Physical symptoms of alcoholism can be broken
into two major categories: symptoms of acute alcohol
use and symptoms of long-term alcohol use.

Immediate (acute) effects of alcohol use

Though the initial reaction to alcohol may be stimu-
latory, ultimately alcohol exerts a depressive, uninhibit-
ing effect on the brain. The blood-brain barrier does not
prevent alcohol from entering the brain, so the brain al-
cohol level quickly becomes equivalent to the blood al-
cohol level. Alcohol’s depressive effects result in im-
paired thinking, feeling and judgment, short term memo-
ry loss, muscle weakness difficulty walking, poor bal-
ance, slurring of speech, and generally poor coordination
(accounting for the increased likelihood of injury and al-
cohol related injury statistics). At higher alcohol levels, a
person’s breathing and heart rate slows. Vomiting may
occur, with a high risk of vomitus “aspiration” (inhaling
vomit into the lungs), and may result in further compli-
cations includingpneumonia. Still higher alcohol levels
may result in coma and death.

Effects of long-term (chronic) alcoholism

Alcohol is considered a lethal poison, requiring con-
tinuous detoxification by the liver. As drinking contin-
ues and overwhelms the liver’s ability to detoxify, long
term consequences to health occur, affecting virtually
every organ system of the body.

NERVOUS SYSTEM. It is estimated that 30-40% of
all men in their teens and twenties have experienced al-
coholic blackout (loss of consciousness) as a result of
drinking a large quantity of alcohol. In an alcoholic
blackout, all memory of time and behavior surrounding
the episode of drinking is lost. Alcohol causes sleep dis-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

turbances, thus affecting overall sleep quality. Numbness
and tingling may occur in the arms and legs. Two condi-
tions that may occur either together or separately are
Wernicke’s and Korsakoff’s syndromes. Both are due to
the depleted thiamin levels found in alcoholics. Wer-
nicke’s syndrome results in disordered eye movements,
very poor balance, and difficulty walking, while Kor-
sakoff’s syndrome severely affects one’s memory, pre-
venting new learning from taking place.

GASTROINTESTINAL SYSTEM. Alcohol causes a loos-
ening of the muscular ring (the cardiac sphincter) that
prevents the stomach’s contents from reentering the
esophagus. As a result, acid from the stomach flows up-
ward into the esophagus, burning those tissues and caus-
ing pain and bleeding, or gastro-esophageal reflux dis-
ease (GERD). Inflammation of the stomach can also re-
sult in bleeding (ulcers) and pain as well as a decreased
desire to eat. A major cause of severe, uncontrollable
bleeding (hemorrhage) in an alcoholic is the develop-
ment in the esophagus of enlarged (dilated) blood ves-
sels, which are called esophageal varices (varicose veins
of the esophagus). These varices actually develop in re-
sponse to the toxic effect of alcohol on the liver, and are
extremely prone to bursting and hemorrhage.

A malnourished state arises from the loss of appetite
for food — due to caloric substitution of alcohol and its ef-
fects on blood sugar levels — and interference with the ab-
sorption of nutrients throughout the intestinal tract. Inflam-
mation of the pancreas (pancreatitis) is a serious and
painful problem in alcoholics that disrupts carbohydrate
and fat digestion, and increases the risk of insulin resis-
tance, weight gain, hyperlipidemia, diabetes, and pancreat-
ic cancer. Diarrhea is also a common symptom of chronic
alcohol use, due to alcohol’s effect on the pancreas.

LIVER. Because alcohol is broken down (metabo-
lized) within the liver, that organ is severely affected by
constant levels of alcohol. Alcohol interferes with the
large number of important chemical processes that occur
in the liver. As alcohol converts to blood sugar, which in
turn converts to blood fat, the liver begins to enlarge, fill-
ing with fat, a condition called fatty liver. Cirrhosis, a
potentially deadly complication, develops when fibrous
tissue, while trying to support the extra burden placed on
the liver by the accumulation of fat and liver cell weak-
ness, interferes with the liver’s normal structure and
function. The liver may also become inflamed, a condi-
tion called hepatitis, producing jaundice, fatigue, and
elevated liver enzymes indicative of liver cell death and
destruction. Because of the liver’s enormous role in di-
gestion, metabolism and immunity, damage to the liver
takes a serious toll throughout the body.

BLOOD. Alcohol can cause changes to any of the
types of blood cells. Red blood cells become abnormally

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

large. White blood cells (important for fighting infec-
tions) decrease in number, resulting in a weakened im-
mune system. This places alcoholics at increased risk for
infections and is thought to account in part for an alco-
holic’s increased risk of cancer (ten times greater than
normal). Platelets and blood clotting factors are affected,
causing an increased risk of bleeding and hemorrhage,
especially when coupled with vascular weaknesses,
varices, or aneurism.

HEART AND CIRCULATORY SYSTEM. Small amounts
of alcohol cause a drop in blood pressure, but increased
use begins to raise blood pressure dangerously. Increased
blood pressure negatively affects the kidneys. While
some studies demonstrate that one to two alcoholic
drinks per night improves heart disease risk values,
higher amounts and chronic intake produce high levels
of circulating fats, which increases the risk of heart dis-
ease. Heavy drinking results in an enlarged heart, coro-
nary arterial disease (CAD), peripheral vascular disease,
weakening of the heart muscle, abnormal heart rhythms,
a risk of blood clots forming within the chambers of the
heart, and a greatly increased risk of stroke. Strokes re-
sult when a blood clot from the heart enters the circula-
tory system, goes to the brain, and blocks a blood vessel.
Stroke may also result from a hemorrhage within the
brain, as weakened vessel walls give way and platelet de-
ficient blood pours through.

REPRODUCTIVE SYSTEM. Heavy drinking has a neg-
ative effect on fertility in both men and women, decreas-
ing testicular and ovarian size, interfering with sperm
and egg production and viability, disrupting menstrual
cycles, and reducing libido. When pregnancy is
achieved reduced quality of sperm and egg may signifi-
cantly and permanently affect the quality of life, pre-,
peri- and postnatally, of the child. A child born to an al-
cohol using woman has a great risk of being born with
fetal alcohol syndrome, which causes distinctive cranial
and facial defects, including a smaller head size, shorten-
ing of the eyelids, and a lowered IQ. Developmental dis-
abilities, heart defects, and behavioral problems are also
more likely.

Diagnosis

The DSM-IV breaks substance abuse into specific
criteria that can be of aid in diagnosing a substance
abuse problem. These criteria are paraphrased here to re-
late to alcoholism. At least one of the following must
have manifested itself within a 12-month period to quali-
fy for a diagnosis of alcohol abuse:

• Recurrent alcohol use that results in failure to fulfill
major role obligations at work, school, or home. Spe-
cific examples are repeated absences from work or

Alcoholism

poor work performance related to alcohol use; alcohol-
related absences, suspensions, or expulsions from
school; and neglect of children or household.

• Recurrent alcohol use in situations in which it is physi-
cally hazardous. Specific examples are driving an auto-
mobile and operating a machine while impaired by al-
cohol use.

• Recurrent alcohol-related legal problems, such as ar-
rests for alcohol-related disorderly conduct.

• Continued alcohol use despite having persistent and re-
curring social or interpersonal problems caused or ex-
acerbated by the effects of the alcohol. Examples in-
clude arguments with a spouse about the consequences
of intoxication, and alcohol-related physical fights.

A diagnosis of alcohol dependence requires habitu-
al, long-term tolerance for and heavy consumption of al-
cohol as well as the development of symptoms of with-
drawal when the amount of alcohol in the system is sub-
stantially lowered or completely stopped. Once a pattern
of compulsive alcohol use has developed, alcohol-depen-
dent people may devote large portions of their time to
the procurement and drinking of alcohol.

A significant number of illnesses categorized in
DSM-IV as alcohol-induced disorders has come into
being as a result of alcohol abuse and dependence, illus-
trating the negative impacts of alcoholism on physical
and mental health. Among the psychiatric diagnoses that
are included in alcohol-induced disorders are:

• dementia

• amnestic disorder

• psychotic disorder

• mood disorder

• anxiety disorder

• sexual dysfunction

• sleep disorder

As previously mentioned, due to the strong element
of denial and a need, usually, for an intervention, diagno-
sis is often brought about because family members call
an alcoholic’s difficulties to the attention of a physician.
A physician may become suspicious when a patient suf-
fers repeated injuries or begins to experience medical
problems that are related to the use of alcohol. In fact,
some estimates suggest that about 20% of a physician’s
patients are alcoholics, a percentage which is higher than
the general population and lower than the increased risk
to health posed by alcoholism. In other words, alcohol
related illness may prompt an alcoholic to see medical
counsel, but their illness may not be recognized as alco-
hol related until the disease toll is quite advanced.

Questionnaires that try to determine what aspects of
a person’s life may be affected by use of alcohol can be
an effective diagnostic aid. Determining the exact quan-
tity of alcohol that a person drinks is much less impor-
tant than determining how his or her drinking affects
health, relationships, jobs, educational goals, and family
life. In fact, because the metabolism of alcohol (how the
body breaks down and processes alcohol) is so individ-
ual, the quantity of alcohol consumed is not part of the
criteria list for diagnosing either alcohol dependence or
alcohol abuse.

One very simple tool for beginning the diagnosis of
alcoholism is called the CAGE questionnaire. It consists
of four questions, with the first letter of each key word
spelling out the word CAGE:

• Have you ever tried to Cut down on your drinking?

• Have you ever been Annoyed by anyone’s comments
about your drinking?

• Have you ever felt Guilty about your drinking?

• Do you ever need an Eye-opener (a morning drink of
alcohol) to start the day?

Other, longer lists of questions may help determine
the severity and effects of a person’s alcohol use. A thor-
ough physical examination may reveal the physical signs
suggestive of alcoholism, such as an enlarged liver, a vis-
ible network of enlarged veins just under the skin around
the navel (called caput medusae) (or herniated umbili-
cus), fluid in the abdomen (ascites), yellowish tone to the
skin (jaundice), decreased testicular size or gynecomas-
tia (breast enlargement in men), osteoporosis, physical
deterioration, loss of teeth, evidence of old injuries, and
poor nutritional status. Diagnostic testing may include
cardiovascular, CNS, GI, general chemistry and liver
function tests (LFTs) and reveal poor stress test perfor-
mance, arterial disease, congestive heart failure, palsy,
loss of coordination, reflux disease or history of stomach
ulcer, irritable bowel syndrome, an increased red blood
cell size and anemia, abnormal white blood cells (cells
responsible for fighting infection) counts or characteris-
tics, abnormal platelets (particles responsible for clot-
ting), and increased liver enzymes. Given the genetic
risk factors for alcoholism, determinations of familiar al-
coholism related illness and death may be additive.

Treatment

Alternative treatments can be a helpful adjunct for
the alcoholic patient once the medical danger of with-
drawal has passed. Because many alcoholics have very
stressful lives (because of, or leading to, the alcoholism),
many of the treatments for alcoholism involve dealing
with and relieving stress. These include massage, medi-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

tation, and hypnotherapy. A list from the Mayo Clinic
also includes acupuncture (may reduce craving, anxi-
ety, depression, tremor, fatigue, and the symptoms of
withdrawal), biofeedback (monitoring of internal systems
for stress reduction), behavioral therapy motivational en-
hancement therapy (problem acknowledgment), and
aversion therapy (may involve simultaneous use of med-
ications the cause nausea or vomiting with relapse.)

Nutritionally oriented practitioners may be consult-
ed to address the malnutrition associated with long-term
alcohol use. Careful and remedial attention toward a
healthier diet and lifestyle, including use of nutritional
supplements, such as vitamins A, B complex, and C; cer-
tain fatty acids; amino acids; zinc; magnesium; and se-
lenium — supplements that support antioxidant, detoxify-
ing, restorative and corrective deficiencies — may further
enhance recovery and lessen the likelihood of relapse.

Herbal treatments include milk thistle ( Silybum
marianum ), which is thought to protect the liver against
damage. Other herbs are thought to be helpful for the pa-
tient suffering through withdrawal. Some of these in-
clude the antidepressive attributes of lavender ( Lavan-
dula officinalis), the calming and restorative nerve toni-
fying effects of skullcap ( Scutellaria lateriflora),
chamomile ( Matricaria recutita), and valerian ( Valeri-
ana officinalis), the stimulating and GI helpful effects of
peppermint ( Mentha piperita), and the bladder aid,
yarrow ( Achillea millefolium).

Allopathic treatment

Allopathic treatment of alcoholism has two parts.
The first phase is the treatment of acute effects of alco-
holism, called detoxification. The second phase involves
learning how to live with the disease of alcoholism.

Withdrawal

Detoxification, or withdrawal, involves helping the
person to rid his or her body of alcohol as well as the
harmful physical effects of the alcohol. Because the per-
son’s body has become accustomed to alcohol, he or she
needs care and monitoring during withdrawal. With-
drawal is an individual experience, depending on the
severity of the alcoholism as measured by the quantity of
alcohol ingested daily and the length of time the patient
has been drinking (the adaptation factor). Withdrawal
symptoms can range from mild to life threatening. Mild
withdrawal symptoms include nausea, ache, diarrhea,
difficulty sleeping, excessive sweating, anxiety, and
trembling. This phase may last from three to seven days.
More severe effects of withdrawal may include halluci-
nations (in which a patient sees, hears, or feels some-
thing that is not real), seizures, an unbearable craving for

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

more alcohol, confusion, fever, fast heart rate, high
blood pressure, and delirium (a fluctuating level of con-
sciousness). Patients at highest risk for the most severe
symptoms of withdrawal (referred to as delirium tremens
or DTs) are those with other medical problems, such as
malnutrition, liver disease, or Wernicke’s syndrome.
Delirium tremens usually begins about three to five days
after the patient’s last drink and may last a number of
days. Withdrawal usually progresses from the more mild
symptoms to the more severe ones.

Patients going through only mild withdrawal, moni-
tored carefully to make sure that more severe symptoms
do not develop, may not require medication, however,
fluids are encouraged to facilitate detoxifying the per-
son’s system. Patients suffering more severe effects of
withdrawal may need to be given sedative medications,
benzodiazepines like Valium or Librium, to relieve dis-
comfort and to avoid the potentially life threatening
complications of high blood pressure, fast heart rate, and
seizures. Because of the patient’s nausea, fluids may
need to be given intravenously (through a vein), along
with some necessary sugars and salts (electrolyte push-
es). It is crucial that thiamin be included in the fluids, be-
cause thiamin is usually quite low in alcoholic patients,
and deficiency of thiamin is responsible for the Wer-
nicke-Korsakoff syndrome. In-patient treatment is usual-
ly short-term (three to seven days), though longer reha-
bilitation programs lasting weeks or even months are
sometimes needed. Any treatment is usually followed by
longer-term outpatient treatment.

Recovery

After the physical problems associated with alcohol
withdrawal have been treated, the more difficult task be-
gins: helping the person to clearly recognize the nature
and severity of his or her illness. This is done on both an
in-patient and outpatient basis. Alcoholism is a disease
of denial; as members of Alcoholics Anonymous put it, it
is “the only disease that keeps telling you that you do not
have a disease.” Recall that often the alcoholic is made
aware of his or her condition through what is called an
intervention, a meeting with family and/or significant
people who describe for the alcoholic the symptoms of
alcoholism that they have witnessed and how these
symptoms have affected them. This is important because
alcoholics who are actively drinking are often not aware
of what they do, nor do they remember later what they
have done. (Interventions are sometimes done before the
problem becomes serious enough to require detoxifica-
tion from alcohol). Essential to recovery is the awareness
of powerlessness over the disease, acceptance of having
the disease, and abstinence from the substance that per-
petuates the disease.

Alcoholism

There is no cure for alcoholism. Sessions led by
peers, such as Alcoholics Anonymous (AA) meetings,
are often part of in-patient hospital treatment. AA meet-
ings, where recovering alcoholics meet regularly and
provide support for each other’s recovery, are considered
among the best methods of preventing a return to drink-
ing (relapse). The AA program is a twelve-step program.
Its steps involve recognizing the destructive power that
alcohol has held over the alcoholic’s life, looking to a
Higher Power for help in overcoming the problem, re-
flecting on the ways in which the use of alcohol has hurt
others, and if possible, making amends to those people.
The final step involves carrying the message of hope and
recovery to other sick and suffering alcoholics. The
Serenity Prayer becomes an ally: “God grant me the
strength to accept the things I cannot change, the
courage to change the things I can change, and the wis-
dom to know the difference.”

The best programs incorporate the alcoholic’s fami-
ly or loved ones into the therapy, because loved ones
have undoubtedly been severely affected by the drinking.
Many therapists believe that families, in an effort to deal
with the alcoholic’s drinking problem, develop patterns
of behavior that unwittingly support or “enable” the pa-
tient’s drinking. This situation is referred to as co-depen-
dency. The twelve-step programs of A1 Anon and Adult
Children of Alcoholics are often very successful in help-
ing the families or loved ones of alcoholics.

There are also medications that may help an alco-
holic avoid returning to drinking. These have been used
with variable success. Disulfiram (Antabuse) is a drug
which, when mixed with alcohol, causes a very unpleas-
ant reaction that includes nausea and vomiting, diarrhea,
and trembling. Naltrexone (a drug that blocks a narcotic
high and may reduce the urge to drink) and acamprosate
seem to be helpful in limiting the effects of a relapse.
Naltrexone, found to produce liver damaging side ef-
fects, may be a difficultly exercised option. None of
these medications has been found to be helpful unless
the patient is also willing to work very hard to change
his or her behavior.

Expected results

As noted earlier, there is no cure for alcoholism. Re-
covery from alcoholism is a lifelong process. In fact,
people who have suffered from alcoholism are encour-
aged to refer to themselves ever after as a recovering al-
coholic, never a recovered alcoholic. Alcoholism can
only be arrested — by abstaining from the drug, alcohol.
The potential for relapse (returning to illness) is always
there, and it must be acknowledged and respected. Sta-
tistics suggest that among middle-class alcoholics in sta-

ble financial and family situations who have undergone
treatment, 60% or more can successfully stop drinking
for at least a year, and many for a lifetime.

Prevention

Prevention is primarily related to education and
early intervention. In a culture where alcohol is so in-
grained, education about the dangers of this drug is vital-
ly important, even as early as early childhood. Since al-
cohol is the easiest and cheapest drug to obtain and the
one most commonly used by teens, the first instance of
intoxication (drunkenness) with alcohol usually occurs
during the teenage years. It is particularly important that
teenagers who are at high risk for alcoholism be made
aware of this danger. Those at high risk include those
with a family history of alcoholism, an early or frequent
use of alcohol, a tendency to drink to drunkenness, alco-
hol use that interferes with schoolwork, a poor family
environment, or a history of domestic violence. Peers are
often the best people to provide this education, and
groups such as SADD (Students Against Drunk Driving,
a Marlborough, Massachusetts-based organization), ap-
pear very effective. Courts and schools sometimes pro-
vide education through local substance abuse programs,
as well. Setting a good example, developing and practic-
ing communication skills with your children, and frank
discussions about the consequences of drinking, are all
encouraged to prevent alcoholism related problems. De-
veloping alternative coping skills to life’s problems is
also essential, as is encouraging a more distant perspec-
tive on the pervasive advertising that deceptively pro-
motes alcohol’s health reducing glamour.

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders. 4th ed. Washington, DC:
American Psychiatric Association, 1994.

Diamond, Ivan. “Alcoholism and Alcohol Abuse.” Cecil Text-
book of Medicine, edited by J. Claude Bennett and Fred
Plum. Philadelphia: W.B. Saunders, 1996.

Schuckit, Marc A. "Alcohol and Alcoholism.” In Harrison's
Principles of Internal Medicine, edited by Anthony S.
Fauci, et al. New York: McGraw-Hill, 1998.

PERIODICALS

Aesoph. Lauri M. “Kick the Habit — Naturally: Quit Drinking
or Smoking With Herbs, Acupuncture, and the Right
Diet.” Vegetarian Times (March 1996): 100+.

Bullock, M. L., P. D. Culliton, and R. T. Oleander. “Controlled
Trial of Acupuncture for Severe Recidivist Alcoholism.”
Lancet (June 1989): 1435-1439.

Dorsman, Jerry. “Improving Alcoholism Treatment: an
Overview.” Behavioral Health Management (January-
February 1996): 26+.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Blood-brain barrier — A membrane that lines the
blood vessels in the brain, it prevents many dam-
aging substances from reaching the brain. Certain
small molecules are able to cross the barrier, in-
cluding water, oxygen, carbon dioxide, and alco-
hol.

Dependence — A state in which a person requires
a steady amount of a particular drug in order to
avoid experiencing symptoms of withdrawal.

Detoxification — The phase of treatment during
which a patient stops drinking and is monitored
and cared for while he or she experiences with-
drawal from alcohol.

Relapse — A return to a disease state after recovery
appeared to be occurring. In alcoholism, relapse
refers to a patient beginning to drink alcohol
again after a period of avoiding it.

Tolerance — A phenomenon whereby a drug user
becomes physically accustomed to a particular
quantity of alcohol (or dosage of a drug), and re-
quires ever-increasing quantities in order to obtain
the same effects.

Withdrawal — Those signs and symptoms experi-
enced by a person who has become physically de-
pendent on a drug, experienced upon decreasing
the drug's dosage or discontinuing its use.

Ianelli, Joseph. “When Alcoholism Hits Home.” American
Journal of Nursing (July 1997): 68+.

O'Brien, Charles P., and A. Thomas McLellan. “Addiction
Medicine.” Journal of the American Medical Association
(June 18, 1997): 1840+.

“Spotting a Drinking Problem.” Consumer Reports on Health
(September 1997): 106+.

ORGANIZATIONS

Al-Anon, Alanon Family Group, Inc. P.O. Box 862, Midtown
Station, New York, NY 10018-0862. (800) 356-9996.
http://www.recovery.org/aa.

National Alliance on Alcoholism and Drug Dependence, Inc.
12 West 21st St., New York, NY 10010. (212) 206-6770.

National Clearinghouse for Alcohol and Drug Information.
<http://www.health.org>.

OTHER

Alcohol Abuse and Alcoholism. MedicineNet, Inc. 1996-2004.
[cited May 28, 2004]. <http://www.medicinet.com>.

Alcoholism. Mayo Foundation for Medical Education and Re-
search. 1998-2004. Updated, July 3, 2002. [cited May 28,
2004], <http://www.mayoclinic.com>.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

FAQs on Alcohol Abuse and Alcoholism. National Institute on
Alcohol Abuse and Alcoholism (NIAAA). Updated,
March 2003. [cited May 28, 2004]. <http://www.maaa.
nih.gov/faq/q-a.htm>.

Katherine E. Nelson, N.D.

Alexander technique

Definition

The Alexander technique is a somatic method for
improving physical and mental functioning. Excessive
tension, which Frederick Alexander, the originator, rec-
ognized as both physical and mental, restricts movement
and creates pressure in the joints, the spine, the breathing
mechanism, and other organs. The goal of the technique
is to restore freedom and expression to the body and
clear thinking to the mind.

Origins

Frederick Matthias Alexander was born in 1869 in
Tasmania, Australia. He became an actor and Shake-
spearean reciter, and early in his career he began to suf-
fer from strain on his vocal chords. He sought medical
attention for chronic hoarseness, but after treatment with
a recommended prescription and extensive periods of
rest, his problem persisted.

Alexander realized that his hoarseness began about
an hour into a dramatic performance and reasoned that it
was something he did in the process of reciting that
caused him to lose his voice. Returning to his medical
doctor, Alexander told him of his observation. When the
doctor admitted that he didn’t know what Alexander was
doing to injure his vocal chords, Alexander decided to
try and find out for himself.

Thus began a decade of self-observation and discov-
ery. Using as many as three mirrors to observe himself in
the act of reciting, normal speaking, and later standing,
walking, and sitting, Alexander managed to improve his
coordination and to overcome his vocal problems. One
of his most startling discoveries was that in order to
change the way he used his body he had to change the
way he was thinking, redirecting his thoughts in such a
way that he did not produce unnecessary tension when
he attempted speech or movement. After making this dis-
covery at the end of the nineteenth century, Alexander
became a pioneer in body-mind medicine.

At first, performers and dancers sought guidance
from Alexander to overcome physical complaints and to

Alexander technique

FREDERICK MATTHIAS
ALEXANDER 1869-1955

Frederick Matthias (F.M.) Alexander was born in
Australia where he began a career as a young actor.
While leading the theater life, he developed chronic
laryngitis. While tragic for a stage career, his lingering
ailment would lead to his discovery of the Alexander
Technique, which would ultimately help people around
the world rid their bodies of tension and stress.

At the age of 1 9, Alexander became frustrated with
a medical practitioner's inability to treat his hoarseness
and was determined to find the cause of his malady. Al-
though lacking any medical training, Alexander began
to meticulously observe his manner of coordination
while speaking and reciting with the use of strategically
placed mirrors. After following this method of study for
1 0 years, Alexander concluded that modern society was
causing individuals to severely misuse the human sys-
tem of locomotion, thus resulting in the dysfunction of
other systems of the body. His experiments and tech-
nique laid the groundwork in the early 1900s for good
habits of coordination or the proper use of the neuro-
muscular system.

Alexander left Australia for London in 1904. The
popularity of the Alexander Technique led him to work
with intellectuals such as George Bernard Shaw and Al-
dous Huxley. Alexander also taught extensively
throughout the United States.

As of 1 995, The Alexander Technique is taught in
26 countries, and there are nine affiliated societies
overseeing a profession of approximately 2,000 teach-
ers of the technique. Alexander's technique continues to
have a profound impact on the training of musicians,
actors, and dancers from around the world.

Beth A. Kapes

improve the expression and spontaneity of their perfor-
mances. Soon a great number of people sought help from
his teaching for a variety of physical and mental disorders.

Benefits

Because the Alexander technique helps students im-
prove overall functioning, both mental and physical, it
offers a wide range of benefits. Nikolaas Tinbergen, in
his 1973 Nobel lecture, hailed the “striking improve-
ments in such diverse things as high blood pressure,
breathing, depth of sleep, overall cheerfulness and men-
tal alertness, resilience against outside pressures, and the
refined skill of playing a musical instrument.” He went

on to quote a list of other conditions helped by the
Alexander technique: “rheumatism, including various
forms of arthritis, then respiratory troubles, and even po-
tentially lethal asthma; following in their wake, circula-
tion defects, which may lead to high blood pressure and
also to some dangerous heart conditions; gastrointestinal
disorders of many types, various gynecological condi-
tions, sexual failures, migraines and depressive states.”

Literature in the 1980s and 1990s went on to include
improvements in back pain, chronic pain, postural prob-
lems, repetitive strain injury, benefits during pregnancy
and childbirth, help in applying physical therapy and reha-
bilitative exercises, improvements in strain caused by com-
puter use, improvements in the posture and performance of
school children, and improvements in vocal and dramatic
performance among the benefits offered by the technique.

Description

The Alexander technique is primarily taught one-on-
one in private lessons. Introductory workshops or work-
shops for special applications of the technique (e.g., work-
shops for musicians) are also common. Private lessons
range from a half-hour to an hour in length, and are taught
in a series. The number of lessons varies according to the
severity of the student’s difficulties with coordination or to
the extent of the student’s interest in pursuing the improve-
ments made possible by continued study. The cost of
lessons ranges from $40-80 per hour. Insurance coverage is
not widely available, but discounts are available for partici-
pants in some complementary care insurance plans. Pre-tax
Flexible Spending Accounts for health care cover Alexan-
der technique lessons if they are prescribed by a physician.

In lessons teachers guide students through simple
movements (while students are dressed in comfortable
clothing) and use their hands to help students identify
and stop destructive patterns of tension. Tensing arises
from mental processes as well as physical, so discus-
sions of personal reactions or behavior are likely to arise
in the course of a lesson.

The technique helps students move with ease and
improved coordination. At the beginning of a movement
(the lessons are a series of movements), most people pull
back their heads, raise their shoulders toward their ears,
over-arch their lower backs, tighten their legs, and other-
wise produce excessive tension in their bodies. Alexan-
der referred to this as misuse of the body.

At any point in a movement, proper use can be es-
tablished. If the neck muscles are not over-tensed, the
head will carry slightly forward of the spine, simply be-
cause it is heavier in the front. When the head is out of
balance in the forward direction, it sets off a series of
stretch reflexes in the extensor muscles of the back. It is

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

skillful use of these reflexes, along with reflex activity in
the feet and legs, the arms and hands, the breathing
mechanism, and other parts of the body, that lessons in
the technique aim to develop.

Alexander found that optimal functioning of the
body was very hard to maintain, even for the short period
of time it took to complete a single movement. People,
especially adults, have very strong tension habits associ-
ated with movement. Chronic misuse of the muscles is
common. It may be caused by slouching in front of tele-
visions or video monitors, too much sitting or driving and
too little walking, or by tension associated with past trau-
mas and injuries. Stiffening the neck after a whiplash in-
jury or favoring a broken or sprained leg long after it has
healed are examples of habitual tension caused by injury.

The first thing a teacher of the Alexander technique
does is to increase a student’s sensory awareness of this
excessive habitual tension, particularly that in the neck
and spine. Next the student is taught to inhibit the ten-
sion. If the student prepares to sit down, for example, he
will tense his muscles in his habitual way. If he is asked
to put aside the intention to sit and instead to free his
neck and allow less constriction in his muscles, he can
begin to change his tense habitual response to sitting.

By leaving the head resting on the spine in its natural
free balance, by keeping eyes open and focused, not held
in a tense stare, by allowing the shoulders to release, the
knees to unlock and the back to lengthen and widen, a
student greatly reduces strain. In Alexander lessons stu-
dents learn to direct themselves this way in activity and
become skilled in fluid, coordinated movement.

Precautions

Side effects

The focus of the Alexander technique is educational.
Teachers use their hands simply to gently guide students
in movement. Therefore, both contraindications and po-
tential physiological side effects are kept to a minimum.
No forceful treatment of soft tissue or bony structure is
attempted, so damage to tissues, even in the case of er-
rors in teaching, is unlikely.

As students’ sensory awareness develops in the course
of Alexander lessons, they become more acutely aware of
chronic tension patterns. As students learn to release exces-
sive tension in their muscles and to sustain this release in
daily activity, they may experience tightness or soreness in
the connective tissue. This is caused by the connective tis-
sue adapting to the lengthened and released muscles and
the expanded range of movement in the joints.

Occasionally students may get light-headed during a
lesson as contracted muscles release and effect the circu-
latory or respiratory functioning.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Forceful contraction of muscles and rigid postures
often indicate suppression of emotion. As muscles re-
lease during or after an Alexander lesson, students may
experience strong surges of emotion or sudden changes
in mood. In some cases, somatic memories surface,
bringing to consciousness past injury or trauma. This can
cause extreme anxiety, and referrals may be made by the
teacher for counseling.

Research & general acceptance

Alexander became well known among the intellectual,
artistic, and medical communities in London, England dur-
ing the first half of the twentieth century. Among Alexan-
der’s supporters were John Dewey, Aldous Huxley, Bernard
Shaw, and renowned scientists Raymond Dart, G.E.
Coghill, Charles Sherrington, and Nikolaas Tinbergen.

Researchers continue to study the effects and appli-
cations of the technique in the fields of education, pre-
ventive medicine, and rehabilitation. The Alexander
technique has proven an effective treatment for reducing
stress, for improving posture and performance in school-
children, for relieving chronic pain, and for improving
psychological functioning. The technique has been
found to be as effective as beta-blocker medications in
controlling stress responses in professional musicians, to
enhance respiratory function in normal adults, and to
mediate the effects of scoliosis in adolescents and adults.

Training & certification

Before his death in 1955, F.M. Alexander formed
the Society for Teachers of the Alexander Technique
(STAT) in London, England. The Society is responsible
for upholding the standards for teachers of the technique.
In the late 1980s, due to rapid growth of the Alexander
teaching profession, STAT authorized replication of its
certification body in many countries worldwide.

The American Society for the Alexander Technique
(AmSAT) oversees the profession in the United States.
Teachers are board certified according STAT standards.
They must receive 1600 hours of training over three
years at an AmSAT approved training program. Alexan-
der Technique International (ATI), a second organization
for teachers in the United States, has varied standards for
teacher certification.

Resources

BOOKS

Caplan, Deborah. Back Trouble - A new approach to prevention

and recovery based on the Alexander Technique. Triad

Communications: 1987.

Dirnon, Theodore. THE UNDIVIDED SELF: Alexander Tech-
nique and the Control of Stress. North Atlantic Books: 1999.

Alexander technique

Alfalfa

KEY TERMS

Direction — Bringing about the free balance of the
head on the spine and the resulting release of the
erector muscles of the back and legs which estab-
lish improved coordination.

Habit — Referring to the particular set of physical
and mental tensions present in any individual.

Inhibition — Referring to the moment in an Alex-
ander lesson when the student refrains from be-
ginning a movement in order to avoid tensing of
the muscles.

Sensory awareness — Bringing attention to the sen-
sations of tension and/or release in the muscles.

Jones, Frank Pierce. Freedom To Change - The Development and
Science of the Alexander Technique. Mouritz: 1997, import-
ed (First published 1976 as Body Awareness in Action.)

PERIODICALS

Stern, Judith C. “The Alexander Technique:An Approach to
Pain Control !’ Lifeline (Summer 1992).

Tinbergen, Nikolaas. “Ethology and Stress Diseases.” England
Science 185 (1974):20-27.

ORGANIZATIONS

American Society for the Alexander Technique, 401 East Market
Street (P.O. Box 835) Charlottesville, VA 22902 USA. (800)
473-0620; or (804) 295-2840. Fax: 804-295-3947. alexan-
dertec@earthlink.net. <http://www.alexandertech.org.>

Alexander Technique International, 1692 Massachusetts Ave. ,3rd
Floor, Cambridge, MA 02138 USA. (888) 321-0856. Fax:
617-497-2615. ati@ati-net.com. <http://www.ati-net.com.>

OTHER

Alexander Technique Resource Guide, (includes list of teach-
ers) AmS AT Books, (800) 473-0620 or (804) 295-2840.

Nielsen, Michael. “A Study of Stress Amongst Professional
Musicians.” STAT Books London, 1994.

Reiser, Samuel. “Stress Reduction and Optimal Psychological
Functioning." Lecture given at Sixth International Mon-
treaus Congress on Stress, 1994.

Sandra Bain Cushman

Alfalfa

Description

Alfalfa is the plant Medicago sativa. There are many
subspecies. It is a perennial plant growing up to 30 in

(0.75 m) in height in a wide range of soil condition. Its
small flowers range from yellow to purple. Alfalfa is
probably native to the area around the Mediterranean
Sea, but it is extensively cultivated as fodder for live-
stock in all temperate climates.

Alfalfa is a member of the legume family. It has the
ability to make nutrients available to other plants both
through its very long, deep (6-16 ft [2-5 m]) root sys-
tem, and because it has a hosts beneficial nitrogen-fixing
bacteria. For these reasons it is often grown as a soil im-
prover or “green manure.” The medicinal parts of alfalfa
are the whole plant and the seeds. It is used both in West-
ern and traditional Chinese medicine. In Chinese it is
called zi mu. Other names for alfalfa include buffalo
grass, buffalo herb, Chilean clover, purple medick, pur-
ple medicle, and lucerne.

General use

Alfalfa has been used for thousands of years in many
parts of the world, as a source of food for people and live-
stock and as a medicinal herb. It is probably more useful
as a source of easily accessible nutrients than as a medici-
nal herb. Alfalfa is an excellent source of most vitamins,
including vitamins A, D, E, and K. Vitamin K is critical
in blood clotting, so alfalfa may have some use in im-
proving clotting. It also contains trace minerals such as
calcium, magnesium, iron, phosphorous, and potassi-
um. Alfalfa is also higher in protein than many other
plant foods. This abundance of nutrients has made alfalfa
a popular tonic for convalescents when brewed into tea.

In addition to using the seeds and leaves as food, al-
falfa has a long history of folk use in Europe as a diuretic
or “water pill.” It is also said that alfalfa can lower cho-
lesterol. Alfalfa is used as to treat arthritis, diabetes, di-
gestive problems, weight loss, ulcers, kidney and bladder
problems, prostate conditions, asthma, and hay fever.
Alfalfa is also said to be estrogenic (estrogen-like).

Alfalfa is not native to the United States and did not
arrive until around 1850. However, once introduced, it
spread rapidly and was adapted by Native Americans as
a food source for both humans and animals. The seeds
were often ground and used as a flour to make mush.
The leaves were eaten as vegetable. The main medical
use for alfalfa in the United States was as a nutritious tea
or tonic.

In China, alfalfa, or zi mu, and a closely related
species tooth-bur clover, Medicago hispida or nan mu xu
have been used since the sixth century. Alfalfa is a minor
herb in traditional Chinese medicine. It is considered to
be bitter in taste and have a neutral nature. Traditional
Chinese healers use alfalfa leaves to cleanse the digestive
system and to rid the bladder of stones.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

The root of alfalfa is used in Chinese medicine to re-
duce fever, improve urine flow, and treat jaundice, kid-
ney stones, and night blindness. Contrary to the West-
ern belief that alfalfa will aid in weight gain, Chinese
herbalists believe that extended use of alfalfa will cause
weight loss.

Alfalfa contains hundreds of biologically active
compounds, making it difficult to analyze and to ascribe
healing properties to any particular component. In addi-
tion to the nutrients mentioned above, alfalfa contains
two to three percent saponin glycosides. In test tube and
animal studies, saponin glycosides have been shown to
lower cholesterol, but there is no evidence that this cho-
lesterol-lowering effect occurs in humans. In addition,
saponin glycosides are known to cause red blood cells to
break open (hemolysis) and to interfere with the body’s
utilization of vitamin E.

No modern scientific evidence exists that alfalfa in-
creases urine output, effectively treats diabetes, aids kid-
ney or bladder disorders, improves arthritis, reduces ul-
cers, or treats respiratory problems. Similarly, there is no
scientific evidence that alfalfa either stimulates the ap-
petite or promotes weight loss. There is no evidence that
alfalfa has any estrogenic effect on menstruation. There

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

is evidence, however, that although for most people alfalfa
is harmless, for some people it can be dangerous to use.

Preparations

Although alfalfa is available as fresh or dried leaf, it
is most often taken as a capsule of powdered alfalfa or as
a tablet. When dried leaves are used, steeping one ounce
of dried leaves in one pint of water for up to 20 minutes
makes a tea. Two cups of this tea are drunk daily.

In traditional Chinese medicine, juice squeezed
from fresh alfalfa is used to treat kidney and bladder
stones. To treat fluid retention, alfalfa leaves are added to
a soup along with bean curd and lard.

Precautions

Although alfalfa is harmless to most people when
taken in the recommended quantities, people with the au-
toimmune disease systemic lupus erythematosus (SLE)
should not take any form of alfalfa. In a well-document-
ed study, people with latent SLE reactivated their symp-
toms by using alfalfa. In another study, monkeys fed al-
falfa sprouts and seeds developed new cases of SLE.

Alfalfa

Alisma

KEY TERMS

Diuretic — Any substance that increases the pro-
duction of urine.

Estrogenic — Having properties that mimic the
functions of the female hormone, estrogen.

People with other autoimmune diseases should stay
away from alfalfa as a precautionary measure. In addi-
tion, some allergic reactions have been reported to alfalfa
tablets contaminated with other substances.

Side effects

No side effects are reported in healthy people using
alfalfa in the recommended doses.

Interactions

There are no studies of the interactions of alfalfa and
traditional pharmaceuticals.

Resources

BOOKS

Chevallier. Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.

Peirce, Andrea. The American Pharmaceutical Association
Practical Grade to Natural Medicines. New York: William
Morrow and Company, 1999.

PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1999.

Tish Davidson

Alisma

Description

Alisma, a member of the plant family Alismataceae,
is a herb commonly used in traditional Chinese medi-
cine (TCM). The medicinal part of the plant is the dried
root of Alisma plantago-aquatica . Alisma is also called
mad-dog weed, water plantain, American water plan-
tain, or northern water plantain. It belongs to a different
species from the edible plantain or cooking banana of the
Caribbean or the plantain that produces psyllium seed.
The Chinese name for alisma is ze xie.

Alisma is a perennial plant that grows aggressively
in shallow water and boggy spots in parts of Europe,

North America, and northern China. Its leaves take dif-
ferent shapes depending on whether the leaves grow
above or in the water. The plant rarely reaches a height
of more than 30 in (0.9 m). There are several subspecies
of Alisma plantago found throughout the world, but their
medicinal uses are the same.

General use

Alisma has been used for centuries in China. It is
also used today in North America and Europe. In the cat-
egories used by traditional Chinese medicine, which
classifies herbs according to energy level (hot, warm,
cool, or cold) as well as taste, alisma is said to have a
cold nature and a sweet, bland taste. It is used primarily
to treat conditions of damp heat associated with the kid-
ney, bladder, and urinary tract.

Alisma is a diuretic and is used to rid the body of
excess water. It has mild and safe tonic qualities that es-
pecially affect the kidney and bladder. It is often com-
bined with other herbs in general tonic formulas. It is
used to treat kidney stones, pelvic infections, nephritis,
and other urinary tract infections, as well as yellowish
discharges from the vagina. Alisma is also believed to
have an antibacterial action that helps control infection.
In China, alisma is also used to help rid the body of
phlegm, to reduce feelings of abdominal bloating, and to
treat diabetes. The herb is also widely used in Japan.

Outside of China, alisma leaves are sometimes used
medicinally. They can be applied externally to bruises
and swellings, or taken internally to treat kidney and uri-
nary tract inflammations. The roots are also used for kid-
ney and urinary tract disorders, as well as to lower blood
pressure and to treat severe diarrhea. A minor homeo-
pathic remedy can also be made from the root.

Modern scientific research shows that alisma does
act as a mild diuretic. In several studies done in Japan,
alisma extracts were shown to reduce artificially induced
swelling in the paws of rats. Studies using human sub-
jects have not been done, but test tube and animal studies
do seem to indicate that there is a scientific basis for
some of the traditional uses of alisma. There is also some
indication that alisma does have a mild antibacterial ef-
fect, but again, evidence in humans is anecdotal and by
observation rather than by controlled trials.

Preparations

Alisma roots are harvested before the plant blooms
and is dried for future use. Fresh root is toxic. Heating or
drying deactivates the poisonous compounds in the root.
If the leaves are used, they must be boiled for a long time
before using. Fresh leaves are also poisonous.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Diuretic — A medication or substance that increas-
es the production of urine.

Alisma is an ingredient in many common Chinese
preparations to improve kidney balance and general
health. These include rehmannia eight and rehmannia six
combination, lycium chrysanthemum and rehmannia
combination, rehmannia and schizandra, rehmannia and
cornus, rehmannia and magnetitum formula, immortal
long life pill, gentiana, and hoeln five. An extract of al-
isma root is commercially available. Some herbalists in-
dicate that a large dose is necessary for alisma to be
completely effective when treating infections, or that it
should be combined with other anti-infective herbs.

Precautions

Fresh alisma roots and leaves are poisonous. Dried
roots or cooked leaves are safe, even in fairly large doses.
However, the kidney infections that alisma is used to
treat can be serious. Anyone who suspects that they have
a kidney infection should see a medical practitioner.

Side effects

Some Chinese herbalists indicate that long-term use
of alisma can irritate the intestines.

Interactions

In China and Japan, alisma is often taken together
with antibiotics for kidney infections without any nega-
tive interactions. Since alisma is primarily an Asian herb,
there is no body of information on how it might interact
with most Western pharmaceuticals.

Resources

BOOKS

Molony, David. Complete Guide to Chinese Herbal Medicine.

New York: Berkeley Books, 1998.

PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1999.

Teegaurden, Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.

ORGANIZATIONS

American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.

Tish Davidson

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Allergic rhinitis see Hay fever

Allergies

Definition

Allergies are abnormal reactions of the immune sys-
tem that occur in response to otherwise harmless sub-
stances.

Description

Allergies are among the most common medical dis-
orders. It is estimated that 60 million Americans, or more
than one in every five people, suffer from some form of
allergy, with similar proportions throughout much of the
rest of the world. Allergy is the single largest reason for
school absence and is a major source of lost productivity
in the workplace.

An allergy is a type of immune reaction. Normally,
the immune system responds to foreign bodies, like
pollen or bacteria, by producing specific proteins called
antibodies that are capable of binding to identifying mol-
ecules (antigens) on the foreign body. This reaction be-
tween antibody and antigen sets off a series of reactions
designed to protect the body from infection. Harmless,
everyday substances trigger this same series of reactions.
This is the condition known as allergy, and the offending
substance is called an allergen.

Allergens enter the body through four main routes:
the airways, the skin, the gastrointestinal tract, and the
circulatory system.

• Airborne allergens cause the sneezing, runny nose, and
itchy, bloodshot eyes of hay fever (allergic rhinitis).
Airborne allergens can also affect the lining of the
lungs, causing asthma, or the conjunctiva of the eyes,
causing conjunctivitis (pink eye).

• Allergens in food can cause itching and swelling of the
lips and throat, cramps, and diarrhea. When absorbed
into the bloodstream, they may cause hives or more se-
vere reactions involving recurrent, non-inflammatory
swelling of the skin, mucous membranes, organs, and
brain (angioedema). Some food allergens may cause
anaphylaxis, a potentially life-threatening condition
marked by tissue swelling, airway constriction, and
drop in blood pressure.

• In contact with the skin, allergens can cause reddening,
itching, and blistering, called contact dermatitis. Skin
reactions can also occur from allergens introduced
through the airways or gastrointestinal tract. This type
of reaction is known as atopic dermatitis.

Allergies

Allergic rhinitis is commonly triggered by
exposure to household dust, animal fur,
or pollen. The foreign substance that
triggers an allergic reaction is called
an allergen.

The presence of an allergen causes the
body's lymphocytes to begin producing
IgE antibodies. The lymphocytes of an
allergy sufferer produce an unusually
large amount of IgE.

Pollen grains

Lymphocyte

In a future exposure to the same substance,
the antibodies on the mast cells bind to the
allergens, and the cells release their histamine.

SECOND EXPOSURE

Histamine travels to receptor sites in the nasal
passages. When histamine molecules enter the
sites they trigger dilation of the blood vessels,
swelling, irritation, and increased production
of mucus.

Antihistamines

Antihistamine drugs block histamine molecules
from entering receptor sites, thus preventing or
reducing swelling, congestion and irritation.

The allergic response. (Illustration by Hans & Cassidy. The Gale Group.)

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Injection of allergens, from insect bites and stings or
drug administration, can introduce allergens directly into
the circulation, where they may cause system-wide re-
sponses (including anaphylaxis), as well as the local re-
sponses like swelling and irritation at the injection site.

People with allergies are not equally sensitive to all
allergens. Allergies may get worse over time. For exam-
ple, childhood ragweed allergy may progress to year-
round dust and pollen allergy. On the other hand, a per-
son may lose allergic sensitivity. Infant or childhood
atopic dermatitis disappears in almost all people. More
commonly, what seems to be loss of sensitivity is instead
a reduced exposure to allergens or an increased tolerance
for the same level of symptoms.

Causes & symptoms

Causes

Immunologists separate allergic reactions into two
main types: immediate hypersensitivity reactions, which
are mainly mast cell-mediated and occur within minutes
of contact with allergen, and delayed hypersensitivity re-
actions, mediated by T cells (a type of white blood cells)
and occurring hours to days after exposure.

In the upper airways and eyes, immediate hypersen-
sitivity reactions cause the runny nose and itchy, blood-
shot eyes typical of allergic rhinitis. In the gastrointesti-
nal tract, these reactions lead to swelling and irritation of
the intestinal lining, which causes the cramping and diar-
rhea typical of food allergy. Allergens that enter the cir-
culation may cause hives, angioedema, anaphylaxis, or
atopic dermatitis.

Allergens on the skin usually cause delayed hyper-
sensitivity reaction. Roving T cells contact the allergen,
setting in motion a more prolonged immune response.
This type of allergic response may develop over several
days following contact with the allergen, and symptoms
may persist for a week or more.

THE ROLE OF INHERITANCE. While allergy to specif-
ic allergens is not inherited, the likelihood of developing
some type of allergy seems to be, at least for many peo-
ple. If neither parent has allergies, the chances of a child
developing allergy is approximately 10-20%; if one par-
ent has allergies, it is 30-50%; and if both have allergies,
it is 40-75%.

COMMON ALLERGENS. The most common airborne
allergens are the following:

• plant pollens

• animal fur and dander

• body parts from house mites (microscopic creatures
found in all houses)

• house dust >

• mold spores

• cigarette smoke

• solvents

• cleaners

Common food allergens include the following:

• nuts, especially peanuts, walnuts, and Brazil nuts

• fish, mollusks, and shellfish

• eggs

• wheat

• milk

• food additives and preservatives

Common causes of contact dermatitis include the
following:

• poison ivy, oak, and sumac

• nickel or nickel alloys

• latex

Insects and other arthropods whose bites or stings
typically cause allergy include the following:

• bees, wasps, and hornets

• mosquitoes

• fleas

• scabies

Symptoms

Symptoms depend on the specific type of allergic re-
action. Allergic rhinitis is characterized by an itchy, runny
nose often with a scratchy or irritated throat due to post-
nasal drip. Inflammation of the thin membrane covering
the eye (allergic conjunctivitis) causes redness, irritation
and increased tearing in the eyes. Asthma causes wheez-
ing, coughing, and shortness of breath. Symptoms of
food allergies depend on the tissues most sensitive to the
allergen and whether it is spread systemically by the cir-
culatory system. Gastrointestinal symptoms may include
swelling and tingling in the lips, tongue, palate or throat;
nausea; cramping; diarrhea; and gas. Contact dermatitis
is marked by reddened, itchy, weepy skin blisters.

Whole body or systemic reactions may occur from
any type of allergen, but are more common following in-
gestion or injection of an allergen. Skin reactions include
the raised, reddened, and itchy patches called hives. A
deeper and more extensive skin reaction, involving more
extensive fluid collection, is called angioedema. Ana-
phylaxis, another reaction, is marked by difficulty
breathing, blood pressure drop, widespread tissue

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Allergies

swelling, heart rhythm abnormalities, lightheadedness,
and in some cases, loss of consciousness.

Diagnosis

Allergies can often be diagnosed by a careful med-
ical history, matching the onset of symptoms to the ex-
posure to possible allergens. Allergy tests can be used to
identify potential allergens. These tests usually begin
with prick tests or patch tests, which expose the skin to
small amounts of allergen to observe the response. Reac-
tion will occur on the skin even if the allergen is normal-
ly encountered in food or in the airways. RAST testing is
a blood test that measures the level of reactive antibodies
in the blood. Provocation tests, most commonly done
with airborne allergens, present the allergen directly
through the route normally involved. Food allergen
provocation tests require abstinence from the suspect al-
lergen for two weeks or more, followed by ingestion of a
measured amount. Provocation tests are not used if ana-
phylaxis is a concern due to the patient’s medical history.

Treatment

Allergic rhinitis

The following can help to relieve the symptoms of
airborne allergies:

• Stinging nettle ( Urtica dioica ) has antihistamine and
anti-inflammatory properties. The common dose is 300
mg four times daily.

• Grape (Vitis vinifera ) seed extract has antihistamine
and anti-inflammatory properties. The usual dose is 50
mg three times daily.

• Ephedra ( Ephedra sinicia), also called ma huang, has
anti-inflammatory activity and is proven effective in treat-
ing allergies. Taken as a tea thrice daily or 12.5-25 mg in
capsule form. Ephedra should not be used for prolonged
periods of time, as it can raise blood pressure, cause rapid
heartbeat, and interfere with adrenal gland function.

• Licorice ( Glycyrrhiza glabra ) has cortisone-like activi-
ty which is anti-inflammatory, stimulates the adrenals,
and relieves allergy symptoms. Can be taken as a tea or
100-300 mg in capsule form. Long term use can result
in sodium retention or potassium loss.

• Chinese skullcap ( Scutellaria baicalensis ) has bron-
chodilator activity, is an anti-inflammatory, and pre-
vents allergic reactions. It is taken in combination with
other herbs.

• Ginkgo ( Ginkgo biloba) seeds are used in Chinese
medicine for wheezing and coughing.

• Echinacea ( Echinacea species) may have anti- inflam-
matory activity and boost the immune system.

• Khellin ( Ammi visnaga ) has bronchodilator activity.

• Cramp ( Viburnum opulus) bark has bronchodilator ac-
tivity.

• Traditional Chinese medicine treats allergic rhinitis
with various species. Patent combination medicines
are: Bu Zhong Yi Qi Wan (Tonify the Middle and Aug-
ment the Qi) and Yu Ping Feng San (Jade Windscreen)
are used for preventing allergies, and Bi Yan Pian
(Rhinitis Infusion) is often prescribed for syptoms af-
fecting the nose.

• The homeopathic remedies Rhus toxicodendron, Apis
mellifica, and Nux vomica have decongestant activities.
They are taken internally.

• Vitamin C has antihistamine and decongestant activities.

• Vitamins A and E are antioxidants and help to pro-
mote normal functioning of the immune system.

• Coenzyme Q 10 may help to promote normal function-
ing of the immune system.

• Zinc may boost the immune system.

• N-acetylcysteine may have decongestant activity.

• Acupuncture has been shown to be as effective as anti-
histamine drugs in treating allergic rhinitis. It is also
used to help prevent allergic reactions by strengthening
the immune system.

Skin reactions

A variety of herbal remedies, either applied topical-
ly or taken internally, can assist in the treatment of con-
tact dermatitis. A poultice made of jewelweed ( Impatiens
species) or chickweed (Stellaria media) can soothe the
skin. A cream or wash containing calendula (Calendula
officinalis), a natural antiseptic and anti-inflammatory
agent, can help heal the rash. Chinese herbal remedies
have been effective in treating atopic dermatitis. The fol-
lowing are homeopathic remedies to be taken internally:

• Apis ( Apis mellifica) for hives that feel better with cold
application and bee stings

• Poison ivy (Rhus toxicodendron) for hives that feel bet-
ter with hot applications and for poison ivy, oak, or
sumac rashes

• Stinging nettle (Urtica mens) for hives

• Marsh tea (Ledum) for itching insect bites

• Croton (Croton tiglium) oil for poison ivy, oak, or
sumac rashes

Food allergies

Food allergy may be managed by oral desensitiza-
tion. Children with allergy to milk, eggs, fish, or apples

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

who followed an oral desensitization procedure devel-
oped resistance to the allergenic food. Oral desensitiza-
tion exposes the patient to allergens in controlled, but in-
creasing, doses. Control subjects, who had avoided the
allergenic food during the study, were still sensitive.

Allopathic treatment

A large number of prescription and over-the-counter
drugs are available for treatment of immediate hypersen-
sitivity reactions. Most of these drugs work by decreas-
ing the ability of histamine to provoke symptoms. Other
drugs counteract the effects of histamine by stimulating
other systems or reducing immune responses in general.

ANTIHISTAMINES. Antihistamines block the hista-
mine receptors on nasal tissue, decreasing the effect of
histamine released by mast cells. They may be used after
symptoms appear, though they seem to prove more ef-
fective when used preventively. A wide variety of anti-
histamines are available.

DECONGESTANTS. Decongestants constrict blood
vessels to counteract the effects of histamine. Nasal
sprays and oral systemic preparations are available. De-
congestants are stimulants and may cause increased
heart rate and blood pressure, headaches, and agitation.
Use of nasal sprays for longer than several days can
cause loss of effectiveness and rebound congestion, in
which nasal passages become more severely swollen
than before treatment.

TOPICAL CORTICOSTEROIDS. Topical corticosteroids
reduce mucous membrane and skin inflammation and are
available by prescription. Allergies tend to become worse
as the season progresses and topical corticosteroids are
especially effective at reducing this seasonal sensitiza-
tion. As a result, they are best started before allergy sea-
son begins. A 2001 study revealed that steroid nasal
sprays work better for seasonal allergies on an as-needed
basis than do antihistamines. Side effects are usually
mild, but may include headaches, nosebleeds, and un-
pleasant taste sensations.

MAST CELL STABILIZERS. Cromolyn sodium prevents
the release of mast cell granules, thereby preventing the
release of histamine and other chemicals contained in
them. Cromolyn sodium is available as a nasal spray and
aerosol (a suspension of particles in gas).

BRONCHODILATORS. Because allergic reactions in-
volving the lungs cause the airways or bronchial tubes to
narrow, bronchodilators, which cause the smooth muscle
lining the airways to open, can be very effective. Bron-
chodilators include adrenaline, albuterol, and theo-
phylline. Other drugs, including steroids, are used to pre-
vent and control asthma attacks.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Immunotherapy >

Immunotherapy, also known as desensitization or al- era
lergy shots, alters the balance of antibody types in the $
body. Injections involve gradually increasing amounts of
allergen, over several weeks or months, with periodic
boosters. Full benefits may take up to several years to
achieve and are not seen at all in about one in five pa-
tients. Individuals receiving all shots will be monitored
closely following each shot because of the small risk of
anaphylaxis, a condition that can result in difficulty
breathing and a sharp drop in blood pressure.

Possible future treatments

In late 2001, a reports stated that a monoclonal anti-
body called omalizumab might be effective in treating
seasonal allergies and preventing related asthma. By
blocking immunoglobulin E (IgE), an antibody that is
found in excessive amounts in those with hay fever, the
drug treats hay fever and helps prevent related asthma.

Trials on the drug continue, and other immune-based
medicines will likely accompany its ultimate release.

Treatment of contact dermatitis

Calamine lotion applied to affected skin can reduce ir-
ritation somewhat. Topical corticosteroid creams are more
effective, though overuse may lead to dry and scaly skin.

Treatment of anaphylaxis

The emergency condition of anaphylaxis is treated
with injection of adrenaline, also known as epinephrine.
People who are prone to anaphylaxis because of food or
insect allergies often carry an “Epi-pen” containing
adrenaline in a hypodermic needle. Prompt injection can
prevent a more serious reaction from developing.

Expected results

Allergies can improve over time, although they
often worsen. While anaphylaxis and severe asthma are
life-threatening, other allergic reactions are not. Learn-
ing to recognize and avoid allergy-provoking situations
allows most people with allergies to lead normal lives.

Prevention

By determining which allergens are causing the reac-
tions, most people can learn to avoid allergic reactions
from food, drugs, and contact allergens. Airborne aller-
gens are more difficult to avoid, although keeping dust
and animal dander from collecting in the house may limit
exposure. Vitamin C may prevent allergy symptoms. Cro-
molyn sodium can be used for allergy prevention.

Allium cepa

KEY TERMS

Allergen — A substance that provokes an allergic
response.

Allergic rhinitis — Inflammation of the mucous
membranes of the nose and eyes in response to an
allergen.

Anaphylaxis — Increased sensitivity caused by pre-
vious exposure to an allergen that can result in
blood vessel dilation and smooth muscle contrac-
tion. Anaphylaxis can result in sharp blood pres-
sure drops and difficulty breathing.

Angioedema — Severe non-inflammatory swelling
of the skin, organs, and brain that can also be ac-
companied by fever and muscle pain.

Antibody — A specific protein produced by the im-
mune system in response to a specific foreign par-
ticle called an antigen.

Antigen — A foreign particle to which the body re-
acts by making antibodies.

Asthma — A lung condition in which the airways
become narrow due to smooth muscle contraction,
causing wheezing, coughing, and shortness of
breath.

Atopic dermatitis — Infection of the skin as a result
of exposure to airborne or food allergens.

Conjunctivitis — Inflammation of the thin lining of
the eye called the conjunctiva.

Contact dermatitis — Inflammation of the skin as a
result of contact with a substance.

Histamine — A chemical released by mast cells that
activates pain receptors and causes cells to be-
come leaky.

Mast cells — A type of immune system cell that is
found in the lining of the nasal passages and eye-
lids and participates in the allergic response by re-
leasing histamine.

T cells — White blood cells that stimulate cells to
create and release antibodies.

Resources

BOOKS

Lawlor G.J., Jr, T.J. Fischer, and D.C. Adelman. Manual of Al-
lergy and Immunology. Boston: Little, Brown and Co.,
1995.

Weil. A. Natural Health, Natural Medicine: A Comprehensive
Manual for Wellness and Self-Care. Boston: Houghton
Mifflin, 1995.

Ying, Zhou Zhong and Jin Hui De. “Common Diseases of
Otorhinolaryngology and Stomatology.’" In Clinical Man-
ual of Chinese Herbal Medicine and Acupuncture. New
York: Churchill Livingston, 1997.

PERIODICALS

Harder, Patty A. “Homeopathic First-Aid for Allergic Reac-
tions.” Better Nutrition. 60 (June 1998): 42.

Patriarca, G., D. Schiavino, E. Nucera, G. Schinco, A. Milani,
and G.B. Gasbarrini. “Food Allergy in Children: Results
of a Standardized Protocol for Oral Desensitization." He-
pato-Gastroenterology. 45 (1998): 52-58.

Plaut, Marshall. “Immune-Based, Tageted Therapy for Allergic
Diseases.” JAMA. The Journal of the American Medical
Association. (December 19, 2001): 3005.

Siegel-Maier, Karyn. “Nettlesome Allergies! Natural Alterna-
tives to Treat Seasonal Sneezing.” Mother Earth News.
(September 1998): 24+ .

“Steroid Nasal Spray Better for Season Allergies than Antihista-
mines.” Immunotherapy Weekly (December 12, 2001): 12.

Belinda Rowland
Teresa Norris

Allergy elimination diet see Elimination diet

Allium cepa

Description

Allium cepa is the common onion. Although it is
usually thought of as a vegetable, A. cepa also has a long
history of medicinal use.

Onions are perennials that are cultivated for food
worldwide. There are many varieties. Most onion bulbs
are white, yellow, or red. The green stems and leaves are
hollow and can reach 3 ft ( 1 m) in height. The plants bear
small flowers that are usually white or purple. The fleshy
bulb that grows below the ground is used medicinally as
well as for food. Onions are members of the lily family.

General use

Onion has been used as a food source for almost as long
as humans have been keeping written records. Their useful-
ness has been discovered independently by many cultures on
several continents. Onions are mentioned in ancient Egypt-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Onion plant. (© PlantaPhile, Germany. Reproduced by permission.)

ian writings and were known in ancient Greece. In medieval
Europe, they were used unsuccessfully to ward off plague.

In North America, Native Americans used onion to
treat insect stings and relieve colds. It is also used in tra-
ditional Chinese medicine. Homeopaths make a tinc-
ture of onion to treat a variety of conditions including
cold, cough, diarrhea, facial paralysis, hay fever, her-
nia, laryngitis, pneumonia, and trauma.

Over the centuries, onion has been used for healing
both internally and externally. Internally, onion has been
recommended to treat colds, cough, bronchitis, whoop-
ing cough, asthma, and other respiratory problems. It is
believed to help loosen congestion in the lungs and ex-
pand the airways.

Onion is also used internally to relieve excess gas and
calm an upset stomach. A mixture of me (Ruta graveolens)
and onion is used to rid the digestive system of parasites.
Onion is also thought to stimulate the appetite.

Onion is believed to have a positive effect on the cir-
culatory system. It has been used as a diuretic to reduce
swelling. It is also thought to help reduce arteriosclerosis
by lowering blood cholesterol levels and preventing the

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

formation of blood clots. Onion has been used to treat
diabetes and is reputed to lower blood sugar levels.

Externally, fresh onion juice is used to prevent bac-
terial and fungal infections. It can be applied to wounds
and stings on the skin, used to remove warts, used to
stimulate hair growth, and even used to reduce unwanted
skin blemishes. Warm onion juice dropped in the ear is
said to help relieve earache. Baked onion is used to
draw pus from abscesses.

Modern scientific research supports many of the tra-
ditional uses for onion. Onion contains thiosulphinate, a
compound that is effective in killing many common bac-
teria, including Salmonella typhi , Pseudomonas aerigi-
nosa, and Escherichia coli. This finding supports the
folk use of onion to treat wounds and skin infections and
possibly its use for an upset stomach.

Even more supportive are small clinical studies on
humans that show that both fresh onions and commercial
onion extracts actually lower blood cholesterol levels,
lower blood pressure and help prevent the formation of
blood clots. Although these studies have been done on
only a small number of people, they are consistently sup-
ported by additional data from animal and test-tube stud-

Allium cepa

Aloe

ies. In addition, many of these properties have been found
in garlic (A. sativum) which is a close relative to onion.

In 1990, scientists detected the presence of a com-
pound in onion that partially blocks the development of in-
flammation. In addition, laboratory animals were protected
against induced asthma with fresh onion juice. Humans
with asthma have also shown reduced allergy-induced con-
striction of the airways when given an extract of onion.
These findings support the traditional folk administration
of onion to treat asthma and respiratory complaints.

Some test-tube and small animal studies suggest that
onion oil can stop the growth of tumors. Whether these
results are applicable to humans remains to be seen, but
in a 1989 study done in China, people who ate large
amounts of vegetables in the Allium family appeared to
have a significantly reduced rate of stomach cancer.

Onion has also been shown to contain antioxidants,
which are compounds that protect the body against free
radicals. Free radicals are highly reactive molecules that
destabilize other molecules and are associated with a
number of degenerative diseases.

The German Federal Health Agency’s Commission
E, established in 1978 to independently review and eval-
uate scientific literature and case studies pertaining to
herb and plant medications, has approved onion as an an-
tibacterial agent. Although many studies are promising,
more information is needed before this endorsement is
extended to other uses of onion. In general, however, it
appears that onion is a healthful vegetable that may con-
fer many medical benefits.

Preparations

Onion is a common vegetable, and can be served
cooked or raw. For medicinal purposes, onion is available
for internal use as a capsule or tablet containing dehydrated
onion or onion extract. A recent study of the antioxidant
activity of onion juice indicates that it is not affected by
heating or boiling.For external use, the juice of fresh onion
is used. A common dose is 1/4-1 cup of raw onions daily
or one teaspoon of juice three times a day. In folk medi-
cine, a cough syrup is made of raw onion liquid and honey.

Precautions

No special precautions are needed when taking
onion medicinally.

Side effects

Although no allergic reactions to the bulb of the onion
are reported, some people develop an allergic rash after han-
dling the leaves of the plant. In addition, windblown parti-
cles of onion leaves and skin have been shown to irritate the
eyes of farm workers employed to harvest the onions.

KEY TERMS

Antioxidant — An enzyme or other organic sub-
stance that is capable of counteracting the damag-
ing effects of oxidation in living tissue. Onion has
been found to contain antioxidants.

Diuretic — Any substance that increases the pro-
duction of urine.

Tincture — An alcohol-based extract prepared by
soaking plant parts.

Interactions

There are no studies of the interaction of onion and
conventional pharmaceuticals. However, given the long
and widespread use of onion as a vegetable, serious in-
teractions appear unlikely.

Resources

BOOKS

Chevallier. Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.

PDR for Herbal Medicines. Montvale. N. J.: Medical Econom-
ics Company, 1999.

Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines New York: William
Morrow and Company, 1999.

PERIODICALS

Hwang, Y. H., et al. “Suspended Onion Particles and Potential
Corneal Injury in Onion Harvesters.” Archives of Environ-
mental Health 57 (January-February 2002): 78-84.
Racchi.M., et al. “Antiradical Activity of Water-Soluble Compo-
nents in Common Diet Vegetables.” Journal of Agricultur-
al and Food Chemistry 50 (February 2002): 1272-1277.

Tish Davidson
Rebecca J. Frey, PhD

Allium sativa see Garlic

Aloe

Description

Appearance

Aloe vera , a member of the lily family, is a spiky,
succulent, perennial plant. It is indigenous to eastern and
southern Africa, but has been spread throughout many of

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

the warmer regions of the world, and is also popularly
grown indoors. There are about 300 identified species,
but Aloe vera (“true aloe”) is the most popular for med-
ical applications. It has also been known as Aloe vulgaris
(“common aloe”) and Aloe barbadensis. The plant has
yellow flowers and triangular, fleshy leaves with serrated
edges that arise from a central base and may grow to
nearly 2 ft (0.6 m) long. Each leaf is composed of three
layers. A clear gel, that is the part of the plant used for
topical application is contained within the cells of the
generous inner portion. Anthraquinones, which exert a
marked laxative effect, are contained in the bitter yellow
sap of the middle leaf layer. The fibrous outer part of the
leaf serves a protective function.

History

Aloe vera has been in use for thousands of years,
and is mentioned in records as long ago as 1750 B.c.
Use of the plant is thought to have originated in Egypt
or the Middle East. It was reputedly used in Egyptian
embalming procedures, as drawings of Aloe vera have
been found on cave walls in the region. Legend has it
that Aloe vera was one of Cleopatra’s secrets for keep-
ing her skin soft. Pliny and Dioscorides of ancient
Greece wrote of the healing effects of this plant. Addi-
tionally, Alexander the Great is said to have acquired
Madagascar so that he could utilize the Aloe vera grow-
ing there to treat soldiers’ wounds. It is also a remedy
which has long been used in the Indian practice of
Ayurvedic medicine.

In the United States, Aloe vera was in use by the
early 1800s, but primarily as a laxative. A turning point
occurred in the mid- 1930s, when a woman with chronic
and severe dermatitis resulting from x-ray treatments
was healed by an application of Aloe vera leaf gel. Suc-
cess with this patient encouraged trials with others suf-
fering from radiation burns. Evidence of the effective-
ness remained anecdotal until 1953, when Lushbaugh
and Hale produced a convincing study, using Aloe vera
to treat beta radiation lesions in rats. Other experimental
protocols have been carried out using animals since that
time, but there is little human research data to describe
the degree of effectiveness of Aloe vera treatment. Some
evidence suggests that it is especially helpful in the el-
derly and other people with impaired health or failing
immune systems.

Biologic components

Aloe vera contains a wealth of substances that are
biologically active. The laxative, and in large doses,
purgative, effects of Aloe vera latex are attributable to a
group of chemicals known as the anthraquinones. Aloin,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Leaves of an aloe plant. (Photograph by Robert J. Huffman.
Field Mark Publications. Reproduced by permission.)

barbaloin, and aloe-emodin, and aloectic acid, are a few
of the anthraquinones contained in the latex layer. The
latest, and perhaps most exciting component discovered
in Aloe vera is a biologically active polysaccharide
known as acetylated mannose, or acemannan. This sub-
stance has been shown to be a highly effective immune
stimulant, with activity against the viruses causing the
flu, measles, and early stages of AIDS. It has been used
effectively against some veterinary cancers, most no-
tably sarcoma, and is being investigated as an agent to be
used to treat cancer in humans. Acemannan is one of
many saccharides contained in Aloe vera. Some of the
others are arabinose, cellulose, galactose, mannose, and
xylose. Prostaglandins are a third important set of com-
pounds, and are thought to play a major role in wound
healing. Aloe vera also contains fatty acids, enzymes,
amino acids, vitamins, minerals, and other substances.
The interaction of all these components produces a fa-
vorable environment for wound healing.

General use

Few botanicals are as well known or as highly
thought of as the Aloe vera plant. Throughout recorded
history, it has been used to keep skin beautiful and re-
store it to health. A frequent moisturizing ingredient in
cosmetics and hair care products, it also promotes the
healing of burns and superficial wounds, but should not
be used on deep or surgical wounds of punctures. Topi-
cal application has been successful in treatment of sun-
burn, frostbite, radiation injuries, some types of der-
matitis, psoriasis, cuts, insect stings, poison ivy, ulcera-
tions, abrasions, and other dermatologic problems. Heal-
ing is promoted by the anti-inflammatory components,
including several glycoproteins and salicylates, and sub-
stances that stimulate growth of skin and connective tis-
sue. Aloe vera contains a number of vitamins and miner-

Aloe

als that are necessary to healing, including vitamin C,
vitamin E, and zinc. It also exerts antifungal and an-
tibacterial effects, and thus helps to prevent wound in-
fections. One study showed it to have a little more activ-
ity than the antiseptic silver sulfadiazine against a num-
ber of common bacteria that can infect the skin. It has
moisturizing and pain relieving properties for the skin
lesions, in addition to healing effects.

Aloe vera gel products may also be used internally.
They should not contain the laxative chemicals found in
the latex layer. There is some evidence that Aloe vera
juice has a beneficial effect on peptic ulcers, perhaps in-
hibiting the causative bacteria, Helicobacter pylori. It ap-
pears to have a soothing effect on the ulcer, and interferes
with the release of hydrochloric acid by the stomach.
Colitis and other conditions of the intestinal tract may
also respond favorably to the internal use of gel products.
Aloe vera has been shown to exert a stabilizing effect on
blood sugar in studies done on mice, indicating a possible
place for it in the treatment of diabetes. One study sug-
gested that giving Aloe vera extract orally to patients with
asthma who are not dependent on steroids could improve
symptoms. A health care provider should be consulted
about these uses. Other suggested, but insufficiently
proven, indications for oral Aloe vera gel include preven-
tion of kidney stones and relief of arthritis pain.

Aloe vera products derived from the latex layer are
taken orally for the laxative effect. They can cause
painful contractions of the bowel if taken in high doses.
Milder measures are recommended first.

The concentration of the immune stimulant aceman-
nan is variable in the natural plant, as well as gel and
juice products, but it is also available in a purified, stan-
dardized, pharmaceutical grade form. An injectable type
is used in veterinary medicine to treat fibrosarcoma and
feline leukemia, a condition caused by a virus in the
same family as AIDS.

Preparations

Commercial products

Choosing effective Aloe vera products can be chal-
lenging. Once a leaf is cut, enzymes start to break down
some of the long chain sugars which make Aloe vera gel
an effective healing product, so it is important for the
plant to have been properly handled and stabilized. Ask
for help in selecting a reputable company to buy from.
When shopping for a product to use for topical healing,
look for Aloe vera to be one of the first products listed to
ensure that it is not too dilute to be efficacious. Commer-
cial, stabilized gel products may not work as well as the
fresh gel, but cold processing is thought to best retain the

beneficial properties. The FDA does not regulate label-
ing of Aloe vera products.

Aloe vera juice is most often the form of the gel that
is used internally. At least half of the juice should be
Aloe vera gel. If laxative properties are not desired, be
sure that the juice does not contain latex. A product that
is made from the whole leaf does not necessarily contain
anthraquinones from the latex layer, as those are water-
soluble and can be separated out during processing. Cap-
sules and tinctures of the gel are also available. Oral
forms of the latex extract are generally capsules, as it is
extremely bitter.

Growing aloe at home

For common topical use, keeping an Aloe vera plant
at home is one of the easiest ways to get the freshest and
most concentrated gel. It is easy to cultivate, requiring
only good drainage, mild temperatures, and occasional
watering. Bring the plant inside if outside temperatures
are less than 40°F (4.4°C). It will tolerate either full or
partial sunlight, but will require more frequent watering
in full sun. Water it only when the soil has become dry.
To use the gel, break off a leaf and cut it lengthwise to
expose the inner layer. Scoop the gel out and apply gen-
erously to the area needing treatment. Discard whatever
gel is not used immediately, as it will degenerate quickly.
The inner portion of the leaf may also be applied directly
to a skin injury, and bound to it.

Precautions

Aloe vera gel is generally safe for topical use, but it
is best to apply it to a small area first to test for possible
allergic reaction. Stinging and generalized dermatitis
may result in individuals who are sensitive to it. The vast
majority of the warnings apply only to products contain-
ing anthraquinones, such as aloin and barbaloin (as well
as the numerous others), which are found in the latex
layer of the plant. Aloe vera latex should not be used in-
ternally by women who are pregnant or lactating, or by
children. This product can cause abortion or stimulate
menstruation. It may pass into the milk of breastfeeding
mothers. People who have abnormal kidney function,
heart disease, or gastrointestinal diseases are best ad-
vised to avoid any product containing Aloe vera latex or
anthraquinones. Prolonged, internal use in high doses
may produce tolerance so that more is required to obtain
the laxative effect. Be aware of the possibility that any
Aloe vera product for internal use that is supposed to
contain only the gel portion can become contaminated
by the anthraquinones of the latex layer. For this reason,
people who have a contraindication for using Aloe vera
latex should use caution when taking an Aloe vera gel
product internally.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

AIDS — Acronym for acquired immune deficiency
syndrome, the disease caused by human immun-
odeficiency viruses (HIV).

Aloe concentrate — Aloe gel from which the water
has been removed.

Aloe gel — Thick, undiluted substance from the
central portion of the aloe leaf.

Aloe juice — A product for oral use, which is com-
posed of at least 50% aloe gel.

Aloe latex — Bitter yellow sap from the middle leaf
layer.

Anthraquinone — A group of chemicals contained
in the latex of the Aloe plant and having strong
laxative properties.

Hyperglycemia — High blood sugar.

Side effects

Internal use of Aloe vera latex may turn the urine
red, and may also cause abdominal pain or cramps when
products containing anthraquinones are consumed.

Interactions

Chronic internal use of products containing Aloe
vera latex may increase the likelihood of potassium loss
when used concomitantly with diuretics or corticos-
teroids. It may possibly compound the risk of toxicity
when used with cardiac glycosides (both prescription
and herbal types) and antiarrhythmic drugs. Absorption
of other oral medications can be decreased. Aloe vera
latex should not be used with other laxative herbs, which
may also lead to excessive potassium loss.

Internal use of Aloe vera gel can cause changes in
blood sugar, so diabetics should monitor blood glucose
levels during use, particularly if insulin or other pharma-
ceuticals are being used to control hyperglycemia.

Topical Aloe vera may enhance the effect of topical
corticosteroids and allow a reduction in the amount of
the steroid being used.

Resources

BOOKS

Bratman, Steven and David Kroll. Natural Health Bible. Prima
Health, 1999.

Chevallier, Andrew. The Encyclopedia of Medicinal Plants. DK
Publishing Inc., 1996.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Jellin, J.M.. F. Batz, and K. Hitchens. Pharmacist’ s Letter/Pre-
scriber's Letter Natural Medicines Comprehensive Data-
base. Therapeutic Research Faculty, 1999.

Murray, Michael T. The Heating Power of Herbs. Prima Health,
1995.

Judith Turner

Alopecia see Hair loss

Alpha-hydroxy

Description

Alpha-hydroxy is a chemical compound derived
from fruit and milk sugars. Alpha-hydroxy acids (AHAs)
are use in topical skin care products to exfoliate, or
slough away, dead skin cells and promote collagen
growth. They can be useful in promoting smoother,
even-toned skin and may reduce the appearance of wrin-
kles and fine lines in some individuals.

AHAs are available in a number of different synthet-
ic and natural formulations. Lactic AHA is derived from
milk products, while glycolic AHA is derived from sug-
arcane. Other AHA compounds include citric acid (from
fruit) and malic acid (from apples).

General use

AHAs work by removing dead cells at the surface of
the skin. In higher concentrations, it promotes collagen
production, which may reduce the appearance of fine
lines and wrinkles in the skin. The acids penetrate deep
into the skin, where they actually begin to damage skin
cells. This skin damage triggers the production of colla-
gen, a fibrous protein and a building block of tissue and
skin, as the body attempts to repair the cell damage.

Cosmetic, over-the-counter preparations of alpha-
hydroxy must contain less than 10% of the compound
according to U.S. Food and Drug Administration (FDA)
regulations. This is a high enough concentration to pro-
mote exfoliation, but not potent enough to generate col-
lagen production. The concentration of AHA required to
produce this effect is only available with a prescription
from a dermatologist or licensed healthcare professional,
or through professionally administered treatments from a
licensed cosmetologist.

Guidelines recommended by the trade regulatory as-
sociation Cosmetic Ingredient Review have been adapted
by the U.S. FDA for consumer AHA products. The Cos-
metic Ingredient Review is a self-regulating agency es-

Alpha-hydroxy

tablished by the Cosmetic, Toiletry, and Fragrance Asso-
ciation to set safety standards for ingredients used by the
cosmetic industry. Trained cosmetologists are permitted
to use AHA concentrations as high as 30%, provided
these products have a pH level of 3.0 or higher. Health-
care professionals such as dermatologists typically use
concentrations as high as 50-70%.

Preparations

AHA preparations are available in over the counter
and prescription gel, lotion, toner, and cream formula-
tions. An over-the-counter formula that contains between
5-8% AHA may be more effective. Because FDA regu-
lates these products as cosmetics and not drugs, the man-
ufacturer is not required to list the strength of AHA on
the package labeling. However, product ingredients must
be listed sequentially in the order of highest concentra-
tion, so products which list AHA compounds second or
third are usually more beneficial than those who list
them in the middle to end of the ingredient list.

The pH level of an AHA product is also important to
the product’s effectiveness. A higher pH level means the
product is less acidic and gentler on the skin, however, a
higher pH can also lessen the overall potency of the
product. The Cosmetic Ingredient Review guidelines for
AHA products specify that consumer AHA products
must have a pH of 3.5 or more.

Depending on their skin type, certain individuals
may find some carrier formulas (i.e., cream, gel, lotion,
toner) more effective than others. Those with dry skin
may find moisturizing AHA creams and lotions more ef-
fective, while individuals with oily skin may prefer a less
oily toner or gel.

Individuals who are prescribed AHA formulations
by a healthcare professional should follow their doctor’s
directions for use of the product.

Precautions

Buy only those AHA products that conform to the
Cosmetic Ingredient Review and FDA recommended
guidelines of 10% or less AHA with a 3.5 or higher pH
level.

Over-the-counter AHA preparations (those with less
than 10% AHA) are designated as cosmetics, rather than
drugs, by the U.S. FDA, and therefore do not have to un-
dergo the rigorous testing, review, and approval process
required of medical products. In addition, labeling for
cosmetics does not require a listing of the concentration
of ingredients, although some manufacturers provide this
information on their labeling voluntarily. Individuals
should try to purchase AHA products that provide de-

tailed ingredient and concentration information to ensure
they are purchasing true AHA ingredients in a therapeu-
tic concentration. In addition, if an individual experi-
ences a reaction to an AHA product, they can use de-
tailed labeling to decide if a lower concentration of the
product is available and may be right for them.

Individuals who are considering using AHA prod-
ucts for the first time, or who are switching the type of
AHA product they use, should perform a skin patch test
to check for skin sensitivity to the substance. A small,
dime sized drop of the AHA product should be applied
to a small patch of skin inside the elbow or wrist. The
skin patch should be monitored for 24 hours to ensure no
excessive redness, swelling, blistering, or rash occurs. If
a reaction does occur, the test can be repeated with an
AHA product with a lower alpha-hydroxy acid concen-
tration. Individuals who experience a severe reaction to a
skin patch test of AHA are advised not to use the prod-
uct. A dermatologist or other healthcare professional
may be able to recommend a suitable alternative.

AHA products may increase sun sensitivity. Individ-
uals using AHA products should use a high SPF (at least
15 SPF) sunscreen over the AHA formula to protect
against burning. Sunscreen should be applied no less
than 15 minutes after the AHA formula is applied to pre-
vent neutralizing the acids. Shading the face with a wide-
brimmed hat may also be useful. Results of a 1999 FDA
study on the use of AHA and UV damage showed that,
while AHA decreases the time required for skin to begin
to burn, discontinuing use of the AHA product returned
skin to normal within a week.

Exfoliative products should be used with care, as
over-exfoliation can cause damage to the skin. AHA
products should not be combined with other exfoliative
products such as facial scrubs, buff pads, or loofahs. In
addition, individuals should only use one AHA product
at a time.

Higher concentration prescription AHA products
have a great likelihood of producing side effects, so indi-
viduals taking them should contact their healthcare
provider immediately if they experience burning, red-
ness, or any other reaction to the product.

Individuals who experience adverse reactions to
AHA treatments should report them to both the manu-
facturer of the product and to the FDA’s Office of Cos-
metics and Colors. A patient’s dermatologist or health-
care provider can also make this report anonymously for
the patient. Although these products do not require FDA
approval for market release, FDA is responsible for mon-
itoring their safety and can initiate a product recall or re-
moval for a specific brand or formulation if enough ad-
verse effects occur to make these steps necessary.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Contact dermatitis — Inflammation and redness of
the skin caused by an irritating substance.

Exfoliate — To shed skin. In skin care, the term ex-
foliate describes the process of removing dead
skin cells.

pH — An abbreviation for potential of hydrogen. A
neutral pH is a pH of 7. Levels below 7 are con-
sidered acidic, and those above 7 alkaline. FDA
recommends that over-the-counter alpha-hydroxy
products have a pH of at least 3.5.

AHA chemical peels and other high concentration
AHA treatments should only be administered by a li-
censed cosmetologist, licensed dermatologist, or other
qualified healthcare professional.

Side effects

Possible side effects of AHA products include:

• Increased sun sensitivity. Individuals who use AHA are
often more sensitive to UV rays.

• Excessive redness and burning. In high concentrations
and/or with individuals with sensitive skin, AHA can
cause redness, burning, and even blistering.

• Swelling. AHA products can cause swelling of the skin
and/or eyes.

• Contact dermatitis. AHA can cause an allergic skin re-
action characterized by rash and itching in some indi-
viduals.

• Skin discoloration. Some cases of AHA-related skin
discoloration have been reported.

The FDA has sponsored a joint study with the Na-
tional Toxicology Program to further assess the long-
term consequences of AHA product use. Results of the
study were not yet available as of July 2000.

Interactions

There are no known interactions between alpha-hy-
droxy acid products and other medications and sub-
stances when administered in recommended strengths.
However, because over-the-counter AHA products are
considered cosmetics and not pharmaceuticals, existing
research on possible interactions is minimal.

Alpha-hydroxy products may enhance the effects of
other products or medications with similar therapeutic
properties.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Resources

BOOKS

Callan, Annette, ed. All About Skin Care. Oxford, UK: Oxford
University Press, 2000.

PERIODICALS

Kurtzweil, Paula. “Alpha Hydroxy Acids.” FDA Consumer. 32,
No. 2 (March/April 1998): 30-6.

ORGANIZATIONS

Cosmetic Ingredient Review. 1101 17th St. N.W. Suite 310,
Washington D.C. 20036-4702. (202) 331-0651. http://
www.cir-safety.org

U.S. Food and Drug Administration. Office of Consumer Af-
fairs. FDA (HFE-88), 5600 Fishers Lane, Rockville, MD
20857. (301) 827-5006. http://www.fda.gov. To report ad-
verse effects of a cosmetic product, call: (800) 270-8869.

Paula Ford-Martin

Alternate nostril breathing see Breath
therapy

Althea occicinal see Marsh mallow

Alzheimer's disease

Definition

Alzheimer’s disease (AD) is the most common form
of dementia, a neurologic disease characterized by loss
of mental ability severe enough to interfere with normal
activities of daily living, lasting at least six months, and
not present from birth. AD usually occurs in old age, and
is marked by a decline in cognitive functions such as re-
membering, reasoning, and planning.

Description

A person with AD usually has a gradual decline in
mental functions, often beginning with slight memory
loss, followed by losses in the ability to maintain employ-
ment, to plan and execute familiar tasks of daily living,
and to reason and exercise judgment. Communication
ability, mood, and personality may also be affected. Most
people who have AD die within eight years of their diag-
nosis, although that interval may be as short as one year
or as long as 20 years. AD is the fourth leading cause of
death in adults after heart disease, cancer, and stroke.

Between two and four million Americans have AD;
that number is expected to grow to as many as 14 million
by the middle of the twenty-first century as the popula-
tion as a whole ages. While a small number of people in

Alzheimer's disease

Diseased tissue from the brain of an Alzheimer’s patient
showing senile plaques within the brain’s gray matter.

(Photograph by Cecil Fox, Photo Researchers, Inc. Reproduced
by permission.)

their 40s and 50s develop the disease (called early-onset
AD), AD predominantly affects the elderly. AD affects
about 3% of all people between ages 65 and 74, about
19% of those between 75 and 84, and about 47% of
those over 85. Slightly more women than men are affect-
ed with AD, but this may be because women tend to live
longer, leaving a higher proportion of women in the most
affected age groups.

The cost of caring for a person with AD is consider-
able, and has been estimated at approximately $174,000
per person over the course of the disease. Most people
with AD are cared for at home; the cost of extended
nursing home care adds substantially to this estimate.

Causes & symptoms

The cause or causes of AD are unknown. Some
strong leads have been found through recent research,
and these have also given some theoretical support to
several new experimental treatments.

AD affects brain cells, mostly those in brain regions
responsible for learning, reasoning, and memory. Autop-
sies of persons with AD show that these regions of the
brain become clogged with two abnormal structures —
neurofibrillary tangles and senile plaques. Neurofibril-
lary tangles are twisted masses of protein fibers inside
nerve cells, or neurons. Senile plaques are composed of
parts of neurons surrounding a group of brain proteins
called beta-amyloid deposits. While it is not clear exact-
ly how these structures cause problems, some re-
searchers now believe that their formation is in fact re-
sponsible for the mental changes of AD, presumably by
interfering with the normal communication between
neurons in the brain.

What triggers the formation of plaques and tangles
is unknown, although there are several possible candi-
dates. Inflammation of the brain may play a role in their
development, and use of nonsteroidal anti-inflammatory
drugs (NSAIDs) seems to reduce the risk of developing
AD. Restriction of blood flow may be part of the prob-
lem, perhaps accounting for the beneficial effects of es-
trogen that increases blood flow in the brain, among its
other effects. Highly reactive molecular fragments called
free radicals damage cells of all kinds, especially brain
cells, which have smaller supplies of protective antioxi-
dants thought to protect against free radical damage.

Several genes have been implicated in AD, includ-
ing the gene for amyloid precursor protein, or APP, re-
sponsible for producing amyloid. Mutations in this gene
are linked to some cases of the relatively uncommon
early-onset forms of AD. In 2001, scientists discovered a
new rare mutation of the APP gene that might lead to
new understanding on how the disease develops and new
treatment possibilities. Other cases of early-onset AD are
caused by mutations in the gene for another protein,
called pre-senilin. AD eventually affects nearly everyone
with Down syndrome, caused by an extra copy of chro-
mosome 21. Other mutations on other chromosomes
have been linked to other early-onset cases.

Potentially the most important genetic link was dis-
covered in the early 1990s on chromosome 19. A gene
on this chromosome, called apoE, codes for a protein in-
volved in transporting lipids into neurons. ApoE occurs
in at least three forms — apoE2, apoE3, and apoE4. Each
person inherits one apoE from each parent, and therefore
can either have one copy of two different forms, or two
copies of one. Compared to those without ApoE4, people
with one copy are about three times as likely to develop
late-onset AD, and those with two copies are almost four
times as likely to do so. Despite this important link, not
everyone with apoE4 develops AD, and people without it
can still have the disease. Why apoE4 increases the
chances of developing AD is not known.

There are several risk factors that increase a per-
son’s likelihood of developing AD. The most significant
one is age; older people develop AD at much higher rates
than younger ones. Another risk factor is having a family
history of AD, Down syndrome, or Parkinson’s disease.
People who have had head trauma or hypothyroidism
may manifest the symptoms of AD more quickly. No
other medical conditions have been linked to an in-
creased risk for AD.

Many environmental factors have been suspected of
contributing to AD, but population studies have not borne
out these links. Among these have been pollutants in
drinking water, aluminum from commercial products, and

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

metal dental fillings. To date, none of these factors has
been shown to cause AD or increase its likelihood. Further
research may yet turn up links to other environmental cul-
prits, although no firm candidates have been identified.

The symptoms of AD begin gradually, usually with
short-term memory loss. Occasional memory lapses are
of course common to everyone, and do not by them-
selves signify any change in cognitive function. The per-
son with AD may begin with only the routine sort of
memory lapse — forgetting where the car keys are — but
progress to more profound or disturbing losses, such as
forgetting that he or she can even drive a car. Becoming
lost or disoriented on a walk around the neighborhood
becomes more likely as the disease progresses. A person
with AD may forget the names of family members, or
forget what was said at the beginning of a sentence by
the time he hears the end.

As AD progresses, other symptoms appear, includ-
ing inability to perform routine tasks, loss of judgment,
and personality or behavior changes. Some patients have
trouble sleeping and may suffer from confusion or agita-
tion in the evening (“sunsetting”). In some cases, people
with AD repeat the same ideas, movements, words, or
thoughts, a behavior known as perseveration. Some pa-
tients may exhibit inappropriate sexual behaviors. In the
final stages of the disease, people may have severe prob-
lems with eating, communicating, and controlling their
bladder and bowel functions.

The Alzheimer’s Association has developed a list of 10
warning signs of AD. A person with several of these symp-
toms should see a physician for a thorough evaluation:

• memory loss that affects job skills

• difficulty performing familiar tasks

• problems with language

• disorientation of time and place

• poor or decreased judgment

• problems with abstract thinking

• misplacing things

• changes in mood or behavior

• changes in personality

• loss of initiative

Other types of dementing illnesses, including some
that are reversible, can cause similar symptoms. It is im-
portant for the person with these symptoms to be evalu-
ated by a professional who can weigh the possibility that
his or her symptoms may have another cause. Approxi-
mately 20% of those originally suspected of having AD
turn out to have some other disorder; about half of these
cases are treatable.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Diagnosis

Diagnosis of AD is complex, and may require office
visits to several different specialists over several months
before a diagnosis can be made. While a confident provi-
sional diagnosis may be made in most cases after thor-
ough testing, AD cannot be definitively diagnosed until
autopsy examination of the brain for senile plaques and
neurofibrillary tangles.

The diagnosis of AD begins with a thorough physi-
cal exam and complete medical history. Except in the
disease’s earliest stages, accurate history from family
members or caregivers is essential. Since there are both
prescription and over-the-counter drugs that can cause
the same mental changes as AD, a careful review of the
patient’s drug, medicine, and alcohol use is important.
AD-like symptoms can also be provoked by other med-
ical conditions, including tumors, infection, and demen-
tia caused by mild strokes (multi-infarct dementia).
These possibilities must be ruled out as well through ap-
propriate blood and urine tests, brain magnetic resonance
imaging (MRI) or computed tomography scans (CT),
tests of the brain’s electrical activity (electroencephalo-
graphs or EEGs), or other tests.

In 2001, researchers demonstrated that postitron
emission tomography (PET) scans could help predict who
might develop memory impairment. Although PET scan-
ning is a relatively new and expensive technology, it is be-
coming more readily available. Several types of oral and
written tests are used to aid in the AD diagnosis and to fol-
low its progression, including tests of mental status, func-
tional abilities, memory, and concentration. Still, the neu-
rologic exam is normal in most patients in early stages.

One of the most important parts of the diagnostic
process is to evaluate the patient for depression and
delirium, since each of these can be present with AD, or
may be mistaken for it. (Delirium involves a decreased
consciousness or awareness of one’s environment.) De-
pression and memory loss are both common in the elder-
ly, and the combination of the two can often be mistaken
for AD. Depression can be treated with drugs, although
some antidepressants can worsen dementia if it is pre-
sent, further complicating both diagnosis and treatment.

A genetic test for the ApoE4 gene is available, but is
not used for diagnosis, because possessing even two
copies does not ensure that a person will develop AD.

Treatment

The mainstay of treatment for a person with AD con-
tinues to be the establishment of daily routines and good
nursing care, providing both physical and emotional sup-
port for the patient. Modifications of the home to increase

Alzheimer's disease

safety and security are often necessary. The caregiver also
needs support. Regular medical care by a practitioner
with a non-defeatist attitude toward AD is important so
that illnesses can be diagnosed and treated properly.

People with AD are also often depressed or anxious,
and may suffer from sleeplessness, poor nutrition, and
general poor health. Each of these conditions is treatable
to some degree. It is important for the person with AD to
eat well and continue to exercise. Professional advice
from a nutritionist may be useful to provide healthy,
easy-to-prepare meals. Finger foods may be preferable to
those requiring utensils to be eaten. Regular exercise (su-
pervised for safety if necessary) promotes overall health.
A calm, structured environment with simple tools that
support orientation (like calendars and clocks) may re-
duce anxiety and increase safety.

Diet and supplements

DIET. The incidence of AD is lower in countries
whose citizens have a diet that is lower in fats and calo-
ries. There have been a few reports that a diet rich with
fish improves mental function in patients with AD or de-
mentia. AD patients treated with essential fatty acids
showed greater improvement in mood and mental func-
tion than patients on placebo. Because of its disease-pre-
venting properties, red wine in moderation may be bene-
ficial to AD patients.

VITAMIN E. Studies have shown that AD patients
have lower blood levels of vitamin E than age matched
control subjects. A large, two year study of moderately
affected AD patients found that taking 2,000 IU of vita-
min E daily significantly delayed disease progression as
compared to patients taking placebo. This delay was
equivalent to that seen with patients taking the drug se-
legiline. Vitamin E is also thought to delay AD onset.
High levels of vitamin E put the patient at higher risk for
bleeding disorders.

THIAMINE (VITAMIN B,). Several small studies to
determine the effectiveness of thiamine (vitamin on
AD have been carried out. Daily doses of 3 g for two to
three months have improved mental function and AD as-
sessment scores. Other studies have shown that thiamine
had no effect on AD patients. Side effects include nau-
sea and indigestion.

COBALAMIN (VITAMIN B 12 ). Although results are
conflicting, some studies have found that AD patients
have lower levels of cobalamin (vitamin B 12 ) than oth-
ers. Some studies have shown that cobalamin supple-
mentation improves memory and mental function in AD
patients whereas other studies have found no effect.

ACETYL-L-CARNITINE. Acetyl-L-carnitine is similar
in structure to the neurotransmitter acetyl-choline. Stud-

ies have shown that 2 g or 3 g of acetyl-L-camitine daily
slows the progression of AD, especially in patients who
developed the disease before age 66. Patients who devel-
oped disease after 66 years of age worsened with treat-
ment. Side effects include increased appetite, body
odor, and rash.

DHEA. DHEA (dehydroepiandrosterone) is a steroid
hormone. There may be a link between decreasing levels
of DHEA in the elderly and development of AD. Studies
on the effect, if any, of DHEA on AD are needed. Side
effects include acne, hair growth, irritability, insomnia,
headache, and menstrual irregularity.

MELATONIN. Melatonin is a hormone that helps to
regulate mood and sleep cycles. The effect of melatonin
treatment on AD is unknown but it may be beneficial in
regulating sleep cycles. The usual dose is 3 mg taken one
to two hours before bedtime. Side effects are drowsiness,
confusion, headache, decreased sex drive, and decreased
body temperature.

Herbals and Chinese medicine

GINKGO. Ginkgo, the extract from the Ginkgo hilo-
ha tree is the most commonly used herbal treatment for
AD. Several studies have been performed to test the ef-
fectiveness of ginkgo for treating AD. The dose range
studied were 120-160 mg daily divided into three doses.
Although results have been mixed, the evidence suggests
that ginkgo is an effective treatment for patients with
mild to moderate AD. Side effects are not common but
include headache, allergic skin reaction, and gastroin-
testinal disturbance. Ginkgo also decreases blood coagu-
lation. Individuals with coagulation or platelet disorders
should use extreme caution and consult a physician be-
fore using ginkgo.

PHYTOESTROGENS. Phytoestrogens may be benefi-
cial in the treatment of AD based on the findings that
women with AD who are on hormone replacement thera-
py have improved mental function and mood. Estrogens
may prevent AD, therefore, phytoestrogens may have the
same effect. Phytoestrogens are mainly found in soy
products.

CLUBMOSS. Huperzine A is a compound isolated
from clubmoss ( Huperzia serrata). Studies have shown
that taking 0. 1-0.4 mg daily improves mental function in
AD patients. Side effects are nausea, muscle cramps,

vomiting, and diarrhea.

Therapies

Music therapy has been shown to be effective in
treating the depression, agitation, wandering, feelings of
isolation, and memory loss associated with AD. AD pa-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

tients have benefited from listening to favorite music or
participating in musical activity. Participation in a music
therapy group was more effective at improving memory
and decreasing agitation than being part of a verbal (talk-
ing) group.

A wide variety of other therapies have been benefi-
cial in the treatment of the psychologic symptoms of
AD. These include:

• Light therapy in the evening to improve sleep cycle dis-
turbances.

• Supportive therapy through touch, compliments, and
displays of affection.

• Sensory stimulation through massage and aromatherapy.

• Socio-environmental therapies use activities fitted to
previous interests, favorite foods, and pleasant sur-
roundings.

• Cognitive therapy to reduce negative perceptions and
learn coping strategies.

• Insight-oriented psychotherapy addresses the patient’s
awareness of his or her disease.

• Dance therapy.

• Validation therapy.

• Reminiscence therapy.

• Reality-oriented therapy.

Nursing care and safety

The nursing care required for a person with AD is
easy to learn. Caregivers will usually need to spend in-
creasing amounts of time grooming the patient as the dis-
ease progresses. The patient may require assisted feeding
early on to make sure that he or she is taking in enough
nutrients. Later on, as movement and swallowing become
difficult, a feeding tube may be placed into the stomach
through the abdominal wall. A feeding tube requires more
attention, but is generally easy to care for if the patient is
not resistant to its use. Incontinence becomes the most dif-
ficult problem to deal with at home, and is a principal rea-
son for pursuing nursing home care. In the early stages,
limiting fluid intake and increasing the frequency of toilet-
ing can help. Careful attention to hygiene is important to
prevent skin irritation and infection from soiled clothing.

In all cases, a person diagnosed with AD should not
be allowed to drive, because of the increased potential for
accidents and the increased likelihood of wandering very
far from home while disoriented. In the home, simple
measures such as grab bars in the bathroom, bed rails on
the bed, and easily negotiable passageways can greatly
increase safety. Electrical appliances should be un-
plugged and put away when not in use. Matches, lighters,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

knives, or weapons should be stored safely out of reach.
The hot water heater temperature may be set lower to pre-
vent accidental scalding. A list of emergency numbers,
including the poison control center and the hospital emer-
gency room, should be posted by the phone.

Care for the caregiver

Family members or others caring for a person with
AD have an extremely difficult and stressful job that be-
comes harder as the disease progresses. It is common for
caregivers to develop feelings of anger, resentment, guilt,
and hopelessness, in addition to the sorrow they feel for
their loved one and for themselves. Depression is an ex-
tremely common consequence. Becoming a member of
an AD caregivers’ support group can be one of the most
important things a family member does, not only for him
or herself, but for the person with AD as well. The loca-
tion and contact numbers for AD caregiver support
groups are available from the Alzheimer’s Association;
they may also be available through a local social service
agency, the patient’s physician, or pharmaceutical com-
panies that manufacture the drugs used to treat AD.
Medical treatment for depression may be an important
adjunct to group support.

Outside help, nursing homes, and

governmental assistance

Most families eventually need outside help to relieve
some of the burden of around-the-clock care for a person
with AD. Personal care assistants, either volunteer or
paid, may be available through local social service agen-
cies. Adult daycare facilities are becoming increasingly
common. Meal delivery, shopping assistance, or respite
care may be available as well. Many families consider
nursing home care when AD advances to the late-stage.

Several federal government programs may ease the
cost of caring for a person with AD, including Social Se-
curity Disability, Medicare, and Supplemental Security
Income. Each of these programs may provide some as-
sistance for care, medication, or other costs, but none of
them will pay for nursing home care indefinitely. Medic-
aid is a state-funded program that may provide for some
or all of the cost of nursing home care, although there are
important restrictions. Details of the benefits and eligi-
bility requirements of these programs are available
through the local Social Security or Medicaid office, or
from local social service agencies.

Allopathic treatment

The only two drugs approved for AD, tacrine hy-
drochloride (Cognex) and donepezil hydrochloride (Ari-
cept), increase the brain levels of the neurotransmitter

Alzheimer's disease

acetylcholine, thereby increasing the communication ability
of the remaining neurons. These drugs can modestly in-
crease cognition and improve the ability to perform normal
activities of daily living. The most significant side effect of
tacrine is an increase in the liver enzyme alanine amino-
transferase (ALT). Patients taking tacrine must have a
weekly blood test to monitor their ALT levels. Other fre-
quent side effects include nausea, vomiting, diarrhea, ab-
dominal pain, indigestion, and skin rash. Donepezil has
two advantages over tacrine: fewer side effects and once
daily dosing. Donepezil does not appear to affect liver en-
zymes and the frequency of abdominal side effects is lower.

Estrogen, the female sex hormone, is widely pre-
scribed for post-menopausal women to prevent osteo-
porosis. Several preliminary studies have shown that
women taking estrogen have lower rates of AD, and
those who develop AD have a slower progression and
less severe symptoms.

Preliminary studies have also suggested a reduced
risk for developing AD in older people who regularly use
nonsteroidal anti-inflammatory drugs (NSAIDs), includ-
ing aspirin, ibuprofen (Advil), and naproxen (Aleve), al-
though not acetaminophen. A 2001 study reported that
those subjects who used NSAIDs for at least two years
were up to 80% less likely to develop Alzheimer’s. Fur-
ther study on the effects of NSAIDs on AD are underway.

Selegiline, a drug used in the treatment of Parkin-
son’s disease, appears to slow the development of AD.
Selegiline is thought to act as an antioxidant, preventing
free radical damage. However, it also acts as a stimulant,
making it difficult to determine whether the delay in
onset of AD symptoms is due to protection from free
radicals or to the general elevation of brain activity from
the stimulant effect.

Psychiatric symptoms, such as depression, anxiety,
hallucinations (seeing or hearing things that aren’t
there), and delusions (false beliefs) may be treated with
drugs if necessary.

Expected results

While Alzheimer’s disease may not be the direct
cause of death, the generally poorer health of a person
with AD increases the risk of life-threatening infection,
including pneumonia. In addition, other diseases com-
mon in old age (cancer, stroke, and heart disease) may
lead to more severe consequences in a person with AD.
On average, people with AD live eight years past their
diagnosis, with a range from 1-20 years.

Prevention

There is currently no sure way to prevent Alzheimer’s
disease, though some of the drug treatments discussed

KEY TERMS

Acetylcholine — One of the substances in the
body that helps transmit nerve impulses.

Dementia — Impaired intellectual function that in-
terferes with normal social and work activities.
Neurofibrillary tangle — Twisted masses of pro-
tein inside nerve cells that develop in the brains of
people with AD.

Neuron — A nerve cell.

Senile plaque — Structures composed of parts of
neurons surrounding brain proteins called beta-
amyloid deposits and found in the brains of peo-
ple with AD.

above may eventually be proven to reduce the risk of de-
veloping the disease. The most likely current candidates
are estrogen, phytoestrogens, NSAIDs, vitamin E, and se-
legiline. In 2001, researchers found preliminary indica-
tions that onest of Alzheimer’s might be tied to choles-
terol levels. Although results must be confirmed by other
scientists, lowering cholesterol in the diet might help pre-
vent onset of the disease.

Resources

BOOKS

Bridges, Barbara J., Therapeutic Caregiving: A Practical
Guide for Caregivers of Persons with Alzheimer’ s and
Other Dementia Causing Diseases. BJB Publishing 16212
Bothell Way S.E., Suite F171 Mill Creek, Washington
98012-1219.

Carrier, Louise, and Henry Brodaty. “Mood and Behaviour
Management.” In Clinical Diagnosis and Management of
Alzheimer’ s Disease. 2nd edition, edited by Serge Gauthi-
er. London: Martin Dunitz, 1999.

Larkin, Marilynn. When Someone You Love Has Alzheimer' s:
What you must know, what you can do, what you should
expect.. Dell, 1995.

Luskin, Frederic M., Ellen M. DiNucci, Kathryn A. Newell,
and William L. Haskell. “Complementary/Alternative
Therapies in Select Populations: Elderly Persons." In
Complementary! Alternative Medicine: An Evidence Based
Approach. Edited by John W. Spencer and Joseph J. Ja-
cobs. St. Louis: Mosby, 1999

Mace, Nancy L., and Peter V. Rabins. The 36- Hour Day. The
John Hopkins University Press, 1995.

PERIODICALS

Gottlieb, Scott R.“NSAIDs Can Lower Risk of Alzheimer’s.”
British Medical Journal 323 no. 7324 (December 1,
2001): 1269.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Mitka M.“PET and Memory Impairment.” JAMA, Journal of
the American Medical Association 286 no. 16 (October
24, 2001 ): 1961 .

Ott, Brian R.. and Norma J. Owens. “Complementary and Al-
ternative Medicines for Alzheimer’s Disease.” Journal of
Geriatric Psychiatry and Neurology 1 1 (1998): 163- 173.

“Alzheimer Chemical Engineers Suggest Alzheimer Onset Tied
to Cholesterol.” Pain and Central Nervous System Week
(December 24, 20011:3.

Stephenson Joan. “Alzheimer Treatment Target?” JAMA, Jour-
nal of the American Medical Association 286 no. 14 (Oc-
tober 10, 2001):1704.

“Wiser Now.” Better Directions. PO Box 35 Spencerville, MD
20868.(800) 999-0795.

ORGANIZATIONS

Alzheimer’s Association. 919 North Michigan Ave., Suite 1000
Chicago, IL 60611. (800) 272-3900 (312) 335-8882. http://
www.alz.org/.

National Institute of Aging, Alzheimer's Education, and Refer-
ral Center. (800) 438-4380.

OTHER

Alzheimer’s Disease Books and Videotapes. http://www.alzhei
mersbooks.com

Belinda Rowland
Teresa G. Odle

Amblyopia see Lazy eye
American elm see Slippery elm
American skullcap see Skullcap

Amino acids

Description

Amino acids are known as the building blocks of
protein, and are defined as the group of nitrogen-contain-
ing organic compounds composing the structure of pro-
teins. They are essential to human metabolism, and to
making the human body function properly for good
health. Of the 28 amino acids known to exist, eight of
them are considered “essential,” defined as those that can
be obtained only through food. These essential amino
acids are tryptophan, lysine, methionine, phenylalaine,
threonine, valine, leucine, and isoleucine. The “non-es-
sential” amino acids include arginine, tyrosine, glycine,
serine, glutmamic acid, aspartic acid, taurine, cycstine,
histidine, proline, alanine, and creatine, which is a com-
bination of arginine, glycine, and methionine.

The human body, minus water, is 75% amino acids.
All of the neurotransmitters (proteins) but one are com-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

posed of amino acids; and 95% of hormones are amino
acids. Amino acids are key to every human bodily func-
tion with every chemical reaction that occurs.

Amino acids occur naturally in certain foods, such as
dairy products, meats, fish, poultry, nuts, legumes, and eggs.
Those sources are considered more complete than vegetable
protein, such as beans, peas, and grains, also considered a
good — even if not complete — source of amino acids.

Amino acids became popular as dietary supplements
by the end of the twentieth century for various uses, in-
cluding fitness training, weight loss, and certain chronic
diseases. Claims exist in holistic medicine that indicate
amino acid supplements taken in the proper dosage can
aid also in fighting depression, allergies, heart disease,
gastrointestinal problems, high cholesterol, muscle
weakness, blood sugar problems, arthritis, insomnia,
bipolar illness, epilepsy, chronic fatigue syndrome,
autism, attention-deficit hyperactivity disorder
(ADHD), and mental exhaustion.

Description

Amino acid therapy as a supplemental aid to a healthy
diet joined the fitness craze in the United States by the end
of the 1990s. According to author Brenda Adderly in Better
Nutrition, in September of 1999, “The creation of new pro-
tein from amino acids and the breaking down of existing
protein into amino acids are ongoing processes in our bod-
ies. If, for example, you are working out and developing
certain muscles, amino acids come to the rescue with new
protein to build muscle cells,” Adderly noted. “Similarly,
when you eat a complete protein, such as meat or beans and
rice, the body breaks down the amino acids in that food for
later use.” Understanding the balance of amino acids in the
body can be often the first clue to understanding why a per-
son suffers many ailments, ranging from depression to
upset stomach to obesity. Deficiencies in the proper bal-
ance of amino acids is likely to occur in those with poor
diets. Because stress, age, infection, and various other fac-
tors including the amount of exercise a person does, can
also affect the levels of amino acids, people with healthy,
nutritious diets could also find that they also suffer deficien-
cies. Adderly adds that, “Not only are the symptoms of
amino acid deficiencies wide ranging, but there are no
RDAs (recommended daily allowances) or other guidelines,
to help us tell if we are least covering all the bases. Add to
that the complicated matter of keeping track of all 28 some
with names most of us have never even heard and the situa-
tion begins to seem overwhelming.”

Essential amino acids

The amino acids, which are derived only from food and
that the body cannot manufacture, perform various functions.

Amino acids

• Tryptophan. This is considered a natural relaxant,
helps alleviate insomnia; helps in the treatment of mi-
graine headaches; helps reduce the risk of artery and
heart spasms; and works with lysine to reduce choles-
terol levels.

• Lysine. Aids in proper absorption of calcium; helps
form collagen for bone cartilage and connective tis-
sues; aids in production of antibodies, hormones, and
enzymes. Research has indicated it also might be effec-
tive against herpes by creating the balance of nutrients
that slows the growth of the virus causing it. A defi-
ciency could result in fatigue, lack of concentration, ir-
ritability, bloodshot eyes, retarded growth, hair loss,
anemia, and reproductive problems.

• Methionine. Properties include providing the primary
source of sulfur that can prevent disorders of the hair,
skin, and nails; lowers cholesterol by increasing the
liver’s production of lecithin; reduces liver fat; protects
kidneys; and promotes hair growth.

• Phenylalaine. This serves the brain by producing nor-
epinephrine, the chemical that is responsible for trans-
mitting the signals between the nerve cells and the
brain; can maintain alertness; reduces hunger pains;
acts as an antidepressant; and improves memory.

• Threonine. Makes up a substantial portion of the colla-
gen, elastin, and enamel protein; serves the liver by pre-
venting buildup; aids the digestive and intestinal tracts
to function better; and acts as a trigger for metabolism.

• Valine. Promotes mental energy; helps with muscle co-
ordination; and serves as a natural tranquilizer.

• Leucine. Works with isoleucine to provide for the man-
ufacture of essential biochemical processes in the body
that are used for energy, increasing the stimulants to the
upper brain for greater mental alertness.

Roles of certain non-essential amino acids

• Glycine. Facilitates the release of oxygen for the
cell-making process; key role in manufacturing of hor-
mones and health of immune system.

• Serine. Source of glucose storage by the liver and mus-
cles; provides antibodies for immune system; synthe-
sizes fatty acid sheath around nerve fibers.

• Glutamic acid. Nature’s “brain food” that increases
mental prowess; helps speed the healing of ulcers; aids
in combatting fatigue.

Creatine in the spotlight

One of the most discussed amino acid supplements

available on the market is creatine monohydrate. The body

produces small amounts of creatine in the kidneys, liver,

and pancreas, making it a non-essential acid. With most
diets that include red meat or fish, also come a few grams
of creatine. It is stored in muscle cells and is used in activ-
ities, such as weight lifting and sprinting, providing the
necessary thrust of energy for such activities. But the nat-
ural supply of creatine produced by the body is quickly
depleted. After approximately 10 seconds, when muscle
fatigue becomes apparent, the daily production is used.

According to Timothy Gower, writing for Esquire in
February of 1998, “Scientists identified creatine 160-
odd years ago, but only in the 1980s did they figure out
that muscle cells can be ‘loaded’ with up to 30% more of
the compound than they normally carry. Since then, sev-
eral studies have shown that weight lifters primed on the
supplement tire less easily, allowing them to work out
longer.” Gower also noted that creatine users find that
the weight they add on is fat-free, whether that is lean
tissue or some is water weight, no one has yet deter-
mined, since muscle cells do fill with water during crea-
tine loading. Additionally, while it can add to the burst of
the energy a sprinter needs to perform well, creatine
does not do anything for the marathon runner going for
several hours.

Commercially available since 1993, the long-term
effects still remain unknown. One 2002 study did show
that creatine use improved rehabilitation for injured ath-
letes and another has shown that using the supplement
does not increase risk of injury. It should be noted that
some 20-30% of people researched showed no improve-
ment using creatine. One early report indicated that crea-
tine could be beneficial for some people in spurring me-
tabolism, burning calories and helping in weight loss.
Those reports were as yet inconclusive.

General use

Amino acid supplements to a healthy diet are used
for various purposes. The most common uses include:
sustaining strength in weight training to build muscles;
improving heart and circulatory problems or diseases,
particularly in the aging; the treatment of chronic fatigue
syndrome; treating depression and anxiety; treating eat-
ing disorders, such as bulimia and/or anorexia, along
with overeating; increasing memory; building up and
sustaining the body’s immune system in fighting bacteria
and viruses. It is important to note that, while the neces-
sity and role of all amino acids has been verified in the
maintenance of optimum health, research is not exten-
sive enough to provide indisputable verification of the
touted benefits of such supplements over the long term.

Nonetheless, some members of the scientific med-
ical community would seem to confirm what amino acid
proponents have long believed to be true. One such study

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

from the Journal of the American College of Cardiology
brought good news for the millions suffering from
chronic heart failure. Dr. Rainer Hambrecht and col-
leagues from the University of Leipzig, (Germany) test-
ed the amino acid L-arginine on 38 heart-failure patients.
Knowing that the human body converted it into nitric
oxide, a chemical that relaxes blood vessels, the re-
searchers gave one group 8 g of it daily for four weeks;
another group simply did forearm exercises; and a third
group combined the supplement with the exercise. The
people who took the supplement alone increased their
blood-vessel dilation by a factor of four, as did the exer-
cise group. Those who took both the supplement and
performed the exercise increased it by six. More recent
studies on arginine in 2002 found that the supplement
may help reduce risk of postoperative infections. Fur-
ther, arginine may enhance women’s sexual function.

Supplements are recommended by alternative med-
ical practitioners particularly for those who are not get-
ting a proper diet, especially vegetarians who might not
be getting a balance of complete protein, as well as ath-
letes, anyone under severe stress, and anyone whose al-
cohol intake level is moderate to high.

Preparations

Supplements of various amino acids are available
primarily in capsule, tablet, or powder form. A common
way of taking amino acids is in a “multiple” amino acid
gel cap. These contain sources of protein from gelatin,
soy, and whey. The market for supplements in wholesale,
retail, and internet sales was estimated to reach into the
millions of dollars, with literally hundreds available. In-
ternet sales were a fast-growing area particularly with
the use of such supplements as creatine powder publi-
cized by well-known Olympic stars and professional ath-
letes. Daily usage of creatine as evident from research
indicated that usage should be leveled at 5 g of powder
in a glass of orange juice, and could be taken up to four
times a day during peak athletic training. Maintenance
dosages were recommended at 5 g once a day.

Side effects

Because amino acids are naturally produced sub-
stances both in the human body and in the protein de-
rived from animal and dairy products, as well as being
present in food combinations such as beans and rice,
such supplements are not regulated by the United States
Food and Drug Administration (FDA), nor are there any
specified daily requirements, and they also do not show
up in either drug or urine tests. Amino acid supplements
might be classified as having no affect at all. Long-term
effects were not yet evident, however, due to the relative-
ly recent phenomenon of use.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Essential amino acids — Eight of the 28 amino
acids known to exist are termed essential for
adults, that are available only through food.
Non-essential amino acids — The remaining amino
acids that are produced in the human body.

Interactions

Interactions of amino acids with drugs has not been

sufficiently studied to determine yet if any adverse ef-
fects result from using amino acids with medications.

Resources

PERIODICALS

Adderly, Brenda. “Amino Acids.” Better Nutrition (September
1999). Available from http://web2.infotrac.galegroup.com.

“Amino acid screening.” Everything You Need to Know about
Medical Tests, Annual. Springhouse Corporation: 1996.
Available from http://web2.infotrac.com.

Antinoro, Linda. “Food and Herbs That Keep Blood Moving,
Prevent Circulatory Problems.” Environmental Nutrition
(February 2000).

“Arginine Seems to Benefit Both Immune and Sexual Re-
sponse.” RN (February 2002): 22.

Austin Nutritional Research. “Amino acids.” Reference Guide
for Amino Acids. 2000. Available from http://www.realtime.
net/anr/aminoacid.html.

Body Trends Fitness Products. "Amino acids.” bodytrends.com
commercial website. (2000). Available from http://www
bodytrends.com.

“Creatine Supplementation Speeds Rehabilitation.” Health and
Medicine Week (January 21, 2002): 6.

Davidson, Tish. “Amino acid disorders screening.” Gale Ency-
clopedia of Medicine. Edition 1. Detroit: 1999. Available
from http://web2.infotrac.galegroup.com.

Dolby, Victoria. “Anxiety? Send herbs, 5-HTP, and amino
acids to the rescue!” Better Nutrition (June 1998). Avail-
able from http://web2.infotrac.galegroup.com.

Gersten, Dennis J., M.D. “Amino Acids: Building Blocks of
Life, Building Blocks of Healing.” The Gersten Institute
for Integrative Medicine. (2000). Available from http://
www.imagery.com.

Gower, Timothy. “Eat Powder! Build Muscle! Burn Calories!”
Esquire (February 1998). Available from http://www.
brittannica.com.

Moyano, D.; Vilaseca, M.AA.; Artuch, R.; and, Lambruschini,
N. “Plasma Amino Acids in Anorexia Nervosa.” Nutrition
Research Newsletter (November 1998). Available from
http://web2.infotrac.com.

"Studies Say Creatine is OK.” Obesity, Fitness & Wellness
Week (January 12, 2002): 12.

Amino acids

Andrographis

Toews, Victoria Dolby. “6 Amino Acids Unleash the Energy.”
Better Nutrition (June 1999). Available from http://web2.
infotrac.com.

Totheroh, Gailon. "Amino Acid Therapy Pays Off.” Christian
Broadcasting Network (10 May 1999). Available from
http://www.cbn.com.

Tuttle, Dave. “Muscle’s little helper.” Men's Fitness (December
1998). Available from http://web2.infotrac.com.

Wernerman, Jan. “Documentation of clinical benefit of specific
amino acid nutrients.” The Lancet (5 September 1998).
Available from http://web2.infotrac.galegroup.com/itw.

Williams, Stephen. “Passing the Acid Test.” Newsweek (27
March 2000).

Jane Spehar
Teresa G. Odle

Amyotrophic lateral sclerosis see Lou

Gehrig's disease

An-mo see Chinese massage

Andrographis

Description

Andrographis is the herb of Andrographis panicula-
ta , a flowering plant in the Acanthaceae family. The
perennial grows wild in thickets throughout south Asia,
although it also may be cultivated. In summer and au-
tumn, clusters of small white flowers appear; it is har-
vested when the flowers begin to bloom. It is traditional-
ly valued as an herbal remedy in China, where it grows
in the Guangdong, Guangxi, Fujian, Yunnan, Sichuan,
Jiangsu, and Jianxi provinces.

In Mandarin, andrographis is called chuan xin lian,
Yi jian xi and Lan he lian, which translate directly as
“thread-the-heart lotus.” The Cantonese term is chyun
sam ling, and the Japanese call it senshinren. English
common names include green chiretta, heart-thread lotus
leaf, and kariyat. Its pharmaceutical names, used to dis-
tinguish it as a medicine, are Herba Andrographitis Pan-
iculatae or alternately Folium Andrographis.

General use

Practitioners of Chinese medicine believe that andro-
graphis affects the large intestine, lung, stomach, bladder,
and liver meridians, or energy pathways in the body. It is
thought to dispel heat (such as that associated with fever
or infection) and is used primarily as a broad-spectrum
antibiotic and immunostimulant for a variety of bacterial,
viral, and parasitic conditions, including influenza, in-
testinal infections, hepatitis, pneumonia, and infected

wounds. Andrographis ’s medicinal properties are consid-
ered very bitter, astringent, cold, dry, and stimulating.

Andrographis is considered most effective for con-
ditions associated with fever, inflammation, and the for-
mation of pus. It clears heat and relieves “fire toxicity”
manifest as sores and carbuncles on the skin. It is also
applied topically for snakebite and eczema. Under the
supervision of a qualified practitioner, it is used as a
uterine stimulant and abortive, to bring on miscarriage or
treat prolonged pregnancy or retained placenta.

Andrographis can also be used as an inexpensive
substitute for another Chinese herb, coptis ( huang lian).

Research on andrographis has generally been conduct-
ed in China and has focused on pharmacological investiga-
tion. Studies indicate that andrographis cultivated in the
plains of Shanghai has significant immune stimulating and
anti-infective qualities. In vitro, it inhibits the growth of
Diplococcus pneumoniae and other bacteria and delays the
deterioration of embryonic renal cells caused by a virus.

Major chemical ingredients include andrographan,
andrographolide, neoandrographolide, paniculide A, 14-
deoxy-1 1-oxyandrographolide, and beta-sitosterol.

Preparations

Andrographis is not generally available in American
health food stores, but it can be found at most Chinese
pharmacies and Asian groceries.

The standard dose ranges from 10-15 grams as a de-
coction (strong tea) or 2-5 milliliters as a tincture. Pow-
der doses range from 0.6 to 1.2 grams. Because the herb
is extremely bitter, it’s recommended that powder be
taken in capsule form.

Practitioners of Chinese medicine commonly com-
bine andrographis in patent formulas along with other
Chinese herbs. The following are the major herbs with
which it is combined and the symptoms for which the
combinations are prescribed.

• Pericarpium Citri Reticulatae (Citrus reticulata, Chen
pi) for cough associated with Lung heat.

• Herba et Radix Houttuyniae Cordatae ( Houttuynia
cordata, yu xing cao) and Semen Benincasae Hispidae
(Benincasa hispida, dong gua ren cao ) for Lung
abcess.

• Flos Lonicerae Japonicae ( Lonicera japonica, jin yin
hua) and Radix Platycodonis Grandiflori ( Platycodon
grandiflorum, jie geng) for early stages of a disease
with fever and sore throat.

• Herba Portulacae Oleraceae (Portulacca oleracea, ma
chi xian ) for dysentery.

• Radix et folium Polygoni Cuspidati (Polygonum cuspi-
datum, hu zhang) and Rhizoma Imperatae Cylindricae

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Cold — In Chinese pathology, the term defines a
condition that has insufficient warmth, either ob-
jective (hypothermia) or subjective (feeling cold).

Decoction — A strong tea brewed for 20-30 min-
utes.

Heat — In Chinese pathology, the term defines a
condition that has excessive heat, either objective
(fever, infection) or subjective (feeling hot).

Meridians — Energetic pathways inside the body
through which Qi flows; also called channels.

Patent formulas — Chinese herbal formulas that
were patented centuries ago and are believed to
be proven over centuries of use and study.

Tincture — A solution of medicinal substance in al-
cohol, usually more or less diluted. Herb tinctures
are made by infusing the alcohol with plant mate-
rial.

Qi — A Chinese medical term denoting active
physiological energy.

( Imperata cylindrical var. major , bai mao gen) for hot,
painful urinary disfunction.

Precautions

According to tradition, andrographis is never used in
cases of deficient, cold intestinal conditions. When used
long-term or in large doses, this bitter and cold herb may
damage stomach qi, causing gastric distress and loss of
appetite.

Andrographis is also capable of producing a miscar-
riage, and thus should be avoided by pregnant women un-
less otherwise directed by a knowledgeable practitioner.

Side effects

Gastric distress and loss of appetite have been noted
when the herb is taken in large doses.

Interactions

No interactions with pharmaceutical drugs have
been noted.

Resources

BOOKS

Bensky, D. and Gamble, Andrew. Chinese Herbal Medicine:
Materia Medica. Revised ed. Eastland Press, 1993.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Fan, W. A Manual of Chinese Herbal Medicine: Principles and
Practice for Easy Reference. Shambala, 1996.

Holmes. P. Jade Remedies: A Chinese Herbal Reference for the
West. Snow Lotus Press, 1996.

Hsu, Hong- Yen, et. al. Oriental Materia Medica: A Concise
Guide. Oriental Healing Arts Institute, 1986.

Erika Lenz

Androstenedione

Description

Androstenedione is a hormone that occurs naturally
in the body, and is one of those responsible for male
characteristics. It is a metabolite of DHEA, and as such,
a direct precursor to the male hormone testosterone. It is
found in some plant matter, notably pollen, and in the
gonads of all mammals.

General use

Supplementation with androstenedione increases
blood levels of testosterone, which among other things,
will lead to an increase in strength and muscle mass. As
such, it is mainly of interest to athletes and bodybuilders,
for whom it has the added benefits of increasing energy
levels, improving levels of nitrogen retention and shorten-
ing muscle recovery time. Androstenedione is safer than
anabolic steroids because it has a far gentler effect on the
body, and potential effects are milder and more transient.

Androstenedione is also taken to improve well
being, and to raise levels of mental alertness. In addition,
it is thought to have a positive effect on sexual perfor-
mance. As androstenedione also aids in the conversion of
fatty tissue to muscle, it could conceivably be considered
an aid to weight loss.

The German patent for androstenedione states that 50
mg administered orally raised testosterone levels from
140-183% above normal, which although impressive, is
considerably less than the increase associated with adminis-
tration of anabolic steroids. Also, it is a precursor, in that the
body retains some control over production of testosterone.

Preparations

When taken orally, androstenedione is metabolized
by a single enzyme into testosterone. Athletes generally
take between 50-300 mg daily, according to how much
time is spent exercising and how much physical im-
provement is required. Dosage is usually sublingual in
the form of a spray or capsules. The spray is felt to be far

Androstenedione

more effective, due to imperfect absorption through the
digestive route.

Levels of testosterone in the blood will begin to rise
approximately 15 minutes after administration of an-
drostenedione supplements. They will remain so for
about three hours, with testosterone levels peaking
roughly 1—1.5 hours after administration.

Precautions

There is, as of July 2000, no reliable research to prove
the claims by supplement companies that androstenedione
is useful. Trials that have been conducted are limited in
size and scope, and generally do not satisfy the criteria set
for medical trials. Some experts warn that as a result of the
short time that androstenedione stays in the system, it is
unlikely to have any significant bodybuilding effects.

Androstenedione is not suitable for pregnant or lactat-
ing women, and should not be taken at all by children.
When taken by women, this supplement may cause hir-
suitism and virilization. Caution should be exercised when
males under the age of 25 years take androstenedione.

Those supplementing with androstenedione on a
regular basis are advised to have “cool down” periods
when the product is not taken. This can either be a cou-
ple of days a week, or one week per month.

Androstenedione is unsuitable for use by men with
prostate cancer or elevated PSA. It may also stimulate
prostate replication, enlarging the prostrate (benign
prostate hypertrophy or cancer). Many experts are skep-
tical of the claims made by supplement companies, be-
cause they say that natural bodily checks and balances
will work against this supplement to ensure that muscle
mass and strength do not exceed normal levels for the in-
dividual. Taking androstenedione at times other than pe-
riods of physical exertion is not recommended, because
of the possible effect on mood.

Because of the complex interaction of hormones
within the body, it is strongly advised that anyone con-
templating supplementing with androstenedione consult
a qualified practitioner.

Whereas anabolic steroids are illegal, androstene-
dione is considered a dietary supplement, and as such is
not governed by the same regulations.

As a result of trials conducted by them, the American
Medical Association issued a statement to the effect that
androstenedione does not raise serum testosterone levels,
and in addition, it may have undesirable side effects.

Side effects

Possible effects on the personality of this type of
hormone should be considered, as high levels of male

KEY TERMS

Anabolic steroids — Synthetic male hormones.
DHEA — Dehydroepiandrosterone, which is basi-
cally a male hormone.

Hirsuitism — The growth of excess hair on the
bodies of women, usually due to a hormone im-
balance.

PSA — Prostatic Specific Antigen, elevated levels of
which are a precondition to the development of
cancer of the prostate gland.

Sublingual — Taken underneath the tongue.
Transient — Of short duration.

Virilization — The development of male character-
istics in women.

hormones have been known to trigger aggressive behav-
ior in some cases, particularly when high doses of the
supplement are involved.

It is also possible that long-term use of androstene-
dione, which is not in accordance with medical recom-
mendations, may eventually have a negative effect on nat-
ural levels of testosterone, due to compensation on the
part of the pituitary gland. This means that, in the long
term, it is possible that supplementation with androstene-
dione may cause a reduction in levels of testosterone.

The androgen effect of androstenedione may cause
males to develop loss of head hair. Other side effects that
have been associated with androstenedione administra-
tion include blurred vision, development of breast-like
tissue, and the development of acne.

Interactions

This supplement should not be taken in conjunction
with other bodybuilding substances, particularly anabol-
ic steroids, unless under the direction of a physician.
Lysophosphatidyl choline, when taken in conjunction
with androstenedione, may enhance absorption.

In addition, manufacturers recommend saw palmet-
to to be taken in conjunction with androstenedione as it
can help reduce associated hair loss, and is useful in
controlling prostate enlargement.

Resources

OTHER

Betterbodz (1995-2000). [cited December 28, 2000], <http://

www.betterbodz.com/androsten edione.html/>

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Nutritionalsupplements.com (1998-2000). [cited December 28,
2000], <http://www.nutritionalsupplements.com/andro5.html/>

Patricia Skinner

Anemarrhena

Description

Anemarrhena ( Anemarrhena asphodeloides or Zhi
Mu) is a rare herb that grows wild in Japan and the
northern part of China. It has a 2,000-year history of use,
and written records of its use date from 200 a.d. It is an
attractive-looking plant that belongs to the lily family. At
the top of three-foot spikes, it has small, fragrant, white
six-petaled flowers that bloom at night. The medicinal
parts are the rhizomes (roots) and the stems. Rhizomes
that are large, hard, and round with pale-yellowish color
inside are best for medicinal use.

General use

Traditional Chinese medicine classifies this herb
as cold (or yin) and bitter. Yin and yang are the two op-
posite energies that complement one another. Yin condi-
tions are described as cold, damp, and deficient, while
yang is characterized by heat, dry, and excess. Anemar-
rhena is used to treat heat disorders, which are caused by
excessive yang or insufficient yin functions. When there
is excessive heat, dryness often follows. For example,
fever — an excessive internal heat symptom — is followed
by thirst, which is a sign of dryness. Traditional Chinese
medicine uses bitter and cold herbs such as anemarrhena
to clear the internal heat and provide moisture to the
lungs and the kidneys.

Because anemarrhena brings moisture and coolness,
it will bring relief to excessive internal heat and dryness
symptoms such as fever, thirst, irritability, racing pulse,
cough, bleeding gums, night sweat, insomnia, and hot
flashes. Anemarrhena has been used in herbal combina-
tions such as Zhi Bai Di Huang Wan to relieve symptoms
such as coughing, ulcers of the mouth, kidney dysfunc-
tion, urinary tract infection, insomnia, restlessness, geni-
tal herpes, and sterility.

Chronic bronchitis

Laboratory studies have shown that anemarrhena
can effectively eradicate infections caused by Staphylo-
coccus aureus, the bacterial strain that often causes lung
infections. Anemarrhena has been effectively used to

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

treat bronchitis as well as exacerbating symptoms of
chronic bronchitis such as chronic coughing.

Tuberculosis

Anemarrhena is also used to treat tuberculosis.
Here, however, laboratory results do not support its use.
When given as 2.5% powder, anemarrhena may slow
down disease progression, but overall it does not reduce
death rates in laboratory mice. At higher dosage (5%
powder), anemarrhena appears to be toxic. More mice
treated with anemarrhena died than in the control group.
Therefore, even though the herb can effectively reduce
the low-grade fever associated with tuberculosis, it is a
poor substitute for conventional antibiotics, which can
cure the disease and prevent death.

Urinary tract infections

Anemarrhena has been used to treat cystitis, an in-
fection of the bladder. Studies have shown that it is ef-
fective against Escherichia coli, which commonly causes
cystitis in women. Therefore, it may be effective against
urinary tract infections caused by this bacterial strain.

Other infections

There is little information available concerning the
use of anemarrhena in other types of infections. Howev-
er, laboratory studies show that anemarrhena has an-
tibacterial activity against Salmonella typhi and Vibrio
cholera, the bacteria that cause salmonella food poison-
ing and cholera, two common infections of the bowels.
Studies also show that anemarrhena may also be effec-
tive against fungal infections.

Oliguria

Anemarrhena provides moisture to dry internal or-
gans. Therefore, it is often used as diuretic to improve
kidney function.

Ulcers of the mouth and/or bleeding gums

Anemarrhena can restore moisture in these oral con-
ditions that exhibit excessive dryness and inflammation.

Diabetes

Because Chinese herbalists believe that yin deficien-
cy is the underlying cause of diabetes, they often use ane-
marrhena to treat this disease. In fact, there is scientific ev-
idence to support its use in the treatment of diabetes. Ani-
mal studies show that anemarrhena contains two pharma-
cologic agents, mangiferin and mangiferin-7-0-beta
glucoside, which appear to increase the effectiveness of
insulin and can lower blood glucose levels. Anemarrhena

Anemarrhena

has the greatest effect in mild to moderate diabetic condi-
tions. However, it does not affect glucose levels in nondia-
betic conditions. Anemarrhena may be combined with Shi
Gao (Gypsum) for additional hypoglycemic effects.

Chemotherapy and radiation side effects

Anemarrhena is often effective in relieving severe
adverse reactions associated with conventional
chemotherapy and radiation treatments in cancer pa-
tients. According to traditional Chinese medicine, x rays
used in radiation treatment and drugs used in chemother-
apy are considered “heat toxins.” These agents are very
toxic so that they can kill tumor cells. But they are also
toxic to the body, causing excessive build-up of heat in-
side the Lungs and damaging the Kidneys.

Menopausal symptoms

Another use of anemarrhena is to treat menopausal
symptoms such as insomnia, hot flashes, and irregular
periods.

High blood pressure

Anemarrhena is often used in combination with
phellodendron and rehmannia to treat high blood pres-
sure conditions in patients with symptoms of Liver-fire
deficiency (dizziness, headache, ringing in the ears,
back pain, insomnia, palpitations, dry eyes, and night
sweat). Recent studies in laboratory animals confirm that
this herb is effective in lowering blood pressure.

Preparations

The usual dosage of anamarrhena is 6-12 g per day.
It is available as a single ingredient or in combinations in
the following forms:

• Powder or pills. Should be taken with warm water on
an empty stomach.

• Decoction. A method often used in traditional Chinese
medicine to make an herbal preparation at home. Herbs,
usually in combination, are simply boiled down to a con-
centrated broth or tea to be taken internally.

Precautions

Anemarrhena should not be used under the follow-
ing conditions:

• watery diarrhea

• chronic loose bowel movements

• hypotension (low blood pressure). (Anemarrhena at
very high dosages can cause severe drops in blood
pressure levels)

Side effects

Animal studies show that anemarrhena, when ad-
ministered intravenously at only moderate dosage, can
cause breathing difficulty and a decrease in blood pres-
sure. High dosages reportedly can cause a severe drop in
blood pressure, respiratory arrest, and even death.

Interactions

Anemarrhena has been known to interact with:

• Iron supplements or multivitamin, multimineral sup-
plements containing iron. Therefore, patients should
take iron supplements at least two hours before or two
hours after the herb.

• Iron pots or pans. Patients should not use iron cooking
utensils to make decoctions as they may alter the chem-
istry of the herb.

Resources

BOOKS

Bensky, Dan, and Andrew Gamble, Chinese Herbal Medicine:
Materia Medica. Rev. ed. Seattle: Eastland Press, 1993.
Molony, David. The American Association of Oriental Medi-
cine’s Complete Guide to Chinese Herbal Medicine. New
York: Philip Lief Group, 1998.

PERIODICALS

Ichiki H., et al. “New Antidiabetic Compounds, Mangiferin
and Its Glucosides.” Biol Pharm Bull. 21 no. 12 (1998):
1389-1390.

Iida Y., et al. “Detection of Antifungal Activity in Anemarrhena
Asphodeloides in Sensitivity BCT Method and Isolation
of Its Active Compounds.” Journal ofAgric Food Chem.
Al no. 2 (Feb 1999): 584-587.

ORGANIZATIONS

American Association of Oriental Medicine (AAOM). 433
Front St., Catasauqua, PA 18032. (610) 266-1433. Fax:
(610) 264-2768. E-mail: AAOMI@aol.com. <http://www.
aaom.org. >

American Foundation of Traditional Chinese Medicine. 505
Beach Street, San Francisco, CA 94133. (415) 776-0502.
American Herbal Products Association. 8484 Georgia Ave.,
Suite 370, Silver Spring, MD 20910. (301) 588-1174.
<http://www.ahpa.org.>

National Center for Complementary and Alternative Medicine;
National Institute of Health. NCCAM Clearinghouse, PO
Box 8218, Silver Spring, MD 20907-8218. (888) 644-
6226. Fax: (301) 495-4957. E-mail: nccam-info@nccam.
nih.gov. <http://nccam.nih.gov.>

OTHER

Choate, Clinton J. “Diabetes: Modern Medicine and Tradition-
al Chinese Medicine-Part Three." HealingPeople.com.
<http://www.healingpeople.eom/ht/EN/articles/2000/3/15/
597.tmpl.>

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Diuretic — A substance that increases the forma-
tion and excretion of urine.

Energy — Includes nonmaterial (eg, Qi) as well as
material (eg, blood) vital forces that create and
sustain life.

Fire — An extremely high internal heat condition
characterized by severe dehydration, red eyes, red
face, constipation, insomnia, and agitation. Fire
often affects Lungs, Liver, and Stomach.

Oliguria — A condition in which the kidneys pro-
duce small amounts of urine.

Greacen, “Molly” Amelia. “The Use of Chinese Herbs and
Other Natural Modalities as Alternatives to Hormone Re-
placement Therapy.” Spanda Medical Company. <http://
spanda.com/articles/hormone.html.>

Rosenberg, Z'ev. “Treating the Undesirable Effects of Radiation
and Chemotherapy with Chinese Medicine.” HealingPeo-
ple.com. <http://www.healingpeople.com/ht/EN/articles/
1999/12/10/1 13.tmpL>

Mai Tran

Anemia

Definition

Anemia is a condition characterized by abnormally
low levels of healthy red blood cells or hemoglobin.

Description

The tissues of the human body need a regular supply of
oxygen to stay healthy. Red blood cells, which contain hemo-
globin that allows them to deliver oxygen throughout the
body, live for only about 120 days. When they die, the iron
they contain is returned to the bone marrow and used to cre-
ate new red blood cells. Anemia can develop when heavy
bleeding causes significant iron loss. It also occurs when
something happens to slow down the production of red blood
cells or to increase the rate at which they are destroyed.

Anemia can be mild, moderate, or severe enough to
lead to life-threatening complications. Over 400 different
types of anemia have been identified. Many of them are
rare. More common anemia types include:

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• iron deficiency anemia

• folic acid deficiency anemia

• vitamin B 12 deficiency anemia

• vitamin C deficiency anemia

• autoimmune hemolytic anemia

• hemolytic anemia

• sickle cell anemia

• aplastic anemia

• anemia of chronic disease

Causes & symptoms

Anemia is caused by bleeding, decreased red blood
cell production, or increased red blood cell destruction.
Poor diet can contribute to vitamin deficiency and iron
deficiency anemia, in which fewer red blood cells are
produced. Hereditary disorders and certain diseases can
cause increased blood cell destruction. However, exces-
sive bleeding is the most common cause of anemia, and
the speed with which blood loss occurs has a significant
effect on the severity of symptoms. Chronic blood loss
may be caused by:

• heavy menstrual flow

• hemorrhoids

• nosebleeds

• cancer

• gastrointestinal tumors

• diverticulosis

• polyposis

• stomach ulcers

• long-term alcohol abuse

Acute blood loss is usually the result of:

• childbirth

• injury

• ruptured blood vessel

• surgery

Iron deficiency anemia

Iron deficiency anemia is the most common form of
anemia in the world. In the United States, iron deficiency
anemia affects about 240,000 toddlers between one and
two years of age and 3.3 million women of childbearing
age. This condition is less common in older children and
in adults over 50, and it rarely occurs in teenage boys
and young men.

Anemia

This illustration shows the microscope view of normal red
blood cells (left) and those in three different types of ane-
mia (from left), iron-deficiency anemia, megaloblastic ane-
mia, and sickle cell anemia. (Photograph by John Bavosi,
Custom Medical Stock Photo. Reproduced by permission.)

The onset of iron deficiency anemia is gradual. The
deficiency begins when the body loses more iron than it
gains from food and other sources. Because depleted
iron stores cannot meet the red blood cells’ needs, fewer
red blood cells develop. In this early stage of anemia, the
red blood cells look normal, but they are reduced in
number. Then the body tries to compensate for the iron
deficiency by producing more red blood cells, which are
characteristically small in size.

Weakness, fatigue, and a run-down feeling may be
signs of mild anemia. Other signs include skin that is
pasty or sallow, or lack of color in the creases of the
palm, gums, nail beds, or lining of the eyelids. Someone
who is weak, tires easily, is often out of breath, and feels
faint or dizzy may be severely anemic. Other symptoms
of anemia are:

• angina pectoris (chest pain)

• headache

• inability to concentrate and/or memory loss

• inflammation of the mouth (stomatitis) or tongue (glos-
sitis)

• insomnia

• irregular heartbeat

• loss of appetite

• nails that are dry, brittle, or ridged

• rapid breathing

• sores in the mouth, throat, or rectum

• sweating

• swelling of the hands and feet

• thirst

• tinnitus (ringing in the ears)

• unexplained bleeding or bruising

• pica (a craving to chew ice, paint, or dirt)

Folic acid deficiency anemia

Folic acid deficiency anemia is the most common
type of megaloblastic anemia, in which red blood cells
are bigger than normal. It is caused by a deficiency of
folic acid, a vitamin that the body needs to produce nor-
mal cells.

Folic acid anemia is especially common in infants
and teenagers. Although this condition usually results
from a dietary deficiency, it is sometimes due to an in-
ability to absorb enough folic acid from foods such as:

•eggs

• fish

• green vegetables

• meat

• milk and cheese

• mushrooms

• yeast

Smoking raises the risk of developing this condition
by interfering with the absorption of vitamin C, which the
body needs to absorb folic acid. Folic acid anemia can be
a complication of pregnancy, when a woman’s body
needs eight times more folic acid than it does otherwise.

Vitamin B n deficiency anemia

Less common in this country than folic acid anemia,
vitamin B 12 deficiency anemia is another type of mega-
loblastic anemia that develops when the body does not

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

absorb enough of this nutrient. Necessary for the creation
of red blood cells, B 12 is found in meat and vegetables.

Large amounts of B 12 are stored in the body, so this
condition may not become apparent until as long as four
years after B 12 absorption slows down or stops. The re-
sulting drop in red blood cell production can cause:

• loss of muscle control

• loss of sensation in the legs, hands, and feet

• soreness or burning of the tongue

• weight loss

• yellow-blue color blindness

The most common form of B 12 deficiency is perni-
cious anemia. Since most people who eat meat or eggs
get enough B 12 in their diets, a deficiency of this vitamin
usually means that the body is not absorbing it properly.
This can occur among people who have had intestinal
surgery or those who do not produce adequate amounts
of intrinsic factor, a chemical secreted by the stomach
lining that combines with B 12 to help its absorption in the
small intestine. Symptoms of pernicious anemia include
problems with movement or balance, a slick tongue, tin-
gling in the hands and feet, confusion, depression, and
memory loss. Pernicious anemia can also damage the
spinal cord. A doctor should be notified whenever symp-
toms of this condition occur.

Pernicious anemia usually strikes people 50-60 years
of age. Eating disorders or an unbalanced diet increases
the risk of developing pernicious anemia. So do diabetes
mellitus, gastritis, stomach cancer, stomach surgery, thy-
roid disease, and family history of pernicious anemia.

Vitamin C deficiency anemia

A rare disorder that causes the bone marrow to man-
ufacture abnormally small red blood cells, vitamin C de-
ficiency anemia results from a severe, long-standing di-
etary deficiency.

Hemolytic anemia

Some people are born with hemolytic anemia. Some
acquire this condition, in which infection or antibodies
destroy red blood cells more rapidly than bone marrow
can replace them.

Hemolytic anemia can enlarge the spleen and accel-
erate the destruction of red blood cells (hemolysis). Other
complications of hemolytic anemia may include pain,
shock, gallstones, and other serious health problems.

Thalassemias

An inherited form of hemolytic anemia, thalassemia
stems from the body’s inability to manufacture as much

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

normal hemoglobin as it needs. There are two categories
of thalassemia, depending on which of the amino acid
chains is affected. (Hemoglobin is composed of four
chains of amino acids.) In alpha-thalassemia, there is an
imbalance in the production of the alpha chain of amino
acids; in beta-thalassemia, there is an imbalance in the
beta chain. Alpha-thalassemias most commonly affect
blacks (25% have at least one gene); beta-thalassemias
most commonly affect people of Mediterranean and
Southeast Asian ancestry.

Characterized by production of red blood cells that
are unusually small and fragile, thalassemia only affects
people who inherit the gene for it from each parent (au-
tosomal recessive inheritance).

Autoimmune hemolytic anemia

Warm antibody hemolytic anemia is the most com-
mon type of this disorder. This condition occurs when
the body produces autoantibodies that coat red blood
cells. The coated cells are destroyed by the spleen, liver,
or bone marrow.

Warm antibody hemolytic anemia is more common
in women than in men. About one-third of patients who
have warm antibody hemolytic anemia also have lym-
phoma, leukemia, lupus, or connective tissue disease.

In cold antibody hemolytic anemia, the body attacks
red blood cells at or below normal body temperature.
The acute form of this condition frequently develops in
people who have had pneumonia, mononucleosis, or
other acute infections. It tends to be mild and short-
lived, and disappears without treatment.

Chronic cold antibody hemolytic anemia is most
common in women and most often affects those who are
over 40 and have arthritis. This condition usually lasts
for a lifetime, generally causing few symptoms. Howev-
er, exposure to cold temperatures can accelerate red
blood cell destruction, causing fatigue, joint aches, and
discoloration of the arms and hands.

Sickle cell anemia

Sickle cell anemia is a chronic, incurable condition
that causes the body to produce defective hemoglobin,
which forces red blood cells to assume an abnormal cres-
cent shape. Unlike normal oval cells, fragile sickle cells
cannot hold enough hemoglobin to nourish body tissues.
The deformed shape makes it hard for sickle cells to pass
through narrow blood vessels. When capillaries become
obstructed, a life-threatening condition called sickle cell
crisis is likely to occur.

Sickle cell anemia is hereditary. It almost always af-
fects people of African or Mediterranean descent. A

Anemia

child who inherits the sickle cell gene from each parent
will have the disease, but a child who inherits the gene
from only one parent will carry the sickle cell trait, but
will not have the disease.

Aplastic anemia

Sometimes curable by bone marrow transplant, but
potentially fatal, aplastic anemia is characterized by de-
creased production of red and white blood cells and
platelets (disc-shaped cells that allow the blood to clot).
This disorder may be inherited or acquired as a result of
recent severe illness, long-term exposure to industrial
chemicals, or use of anticancer drugs and certain other
medications.

Anemia of chronic disease

Cancer, chronic infection or inflammation, and kid-
ney and liver disease often cause mild or moderate ane-
mia. Chronic liver failure generally produces the most
severe symptoms.

Diagnosis

Personal and family health history may suggest the
presence of certain types of anemia. Laboratory tests that
measure the percentage of red blood cells or the amount
of hemoglobin in the blood are used to confirm diagnosis
and determine which type of anemia is responsible for a
patient’s symptoms. X rays and examinations of bone
marrow may be used to identify the source of bleeding.

Treatment

Anyone who has anemia caused by poor nutrition
should modify his or her diet to include more vitamins,
minerals, and iron. Foods such as lean red meats, dried
beans and fruits, liver, poultry, and enriched breads and
cereals are all good sources of iron. In addition, eating
foods rich in vitamin C such as citrus fruits and juices
can promote the absorption of iron.

Patients diagnosed with iron-deficiency anemia
should undergo a thorough physical examination and
medical history to determine the cause of the anemia,
particularly if chronic or acute blood loss is suspected.
The cause of a specific anemia will determine the type of
treatment recommended.

Anemia due to nutritional deficiencies can usually
be treated at home with iron supplements or self admin-
istered injections of vitamin B 12 . People with folic acid
anemia should take oral folic acid replacements. Vitamin
C deficiency anemia can be cured by taking daily sup-
plements of vitamin C.

Many therapies for iron-deficiency anemia focus on
adding iron-rich foods to the diet or on techniques to
improve circulation and digestion. Iron supplementa-
tion, especially with iron citrate (less likely to cause
constipation), can be given in combination with herbs
that are rich in iron. Some examples of iron-rich herbs
are dandelion ( Taraxacum officinale ), parsley (Pet-
roselinum crispum ), and nettle ( Urtica dioica). The
homeopathic remedy ferrum phosphoricum (iron sul-
fate) can also be helpful.

An iron-rich herbal tonic can also be made using the
following recipe:

• Soak one-half ounce of yellow dock root and one-half
ounce dandelion root in 1 qt of boiled water for 4-8
hours.

• Simmer until the amount of liquid is reduced to 1 cup.

• Remove from heat and add one-half cup black strap
molasses, mixing well.

• Store in refrigerator: take one-quarter cup daily.

Other herbal remedies known to promote digestion
are prescribed to treat iron-deficiency anemia. Gentian
(■ Gentiana luted) is widely used in Europe to treat ane-
mia and other nutritionally-based disorders. The bitter
qualities of gentian help stimulate the digestive system,
making iron and other nutrients more available for ab-
sorption. This bitter herb can be brewed into tea or pur-
chased as an alcoholic extract (tincture).

Other herbs recommended to promote digestion in-
clude:

• anise ( Pimpinella anisum)

• caraway (Carum carvi )

• cumin ( Cuminum cyminum)

• linden (Tilia spp.)

• licorice ( Glycyrrhiza glabra)

Traditional Chinese treatments for anemia include:

• acupuncture to stimulate a weakened spleen

• asian ginseng ( Panax ginseng) to restore energy

• dong quai ( Angelica sinensis) to control heavy men-
strual bleeding

• a mixture of dong quai and Chinese foxglove ( Rehman -
nia glutinosa) to clear a sallow complexion

• astragalus ( Astragalus membranaceus) to treat pallor
and dizziness

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Allopathic treatment

Surgery may be necessary to treat anemia caused by
excessive loss of blood. Transfusions of red blood cells
may be used to accelerate production of red blood cells.

Medication or surgery may also be necessary to con-
trol heavy menstrual flow, repair a bleeding ulcer, or re-
move polyps (growths or nodules) from the bowels.

Patients with thalassemia usually do not require
treatment. However people with a severe form may re-
quire periodic hospitalization for blood transfusions
and/or bone marrow transplantation.

Sickle cell anemia

Treatment for sickle cell anemia involves regular
eye examinations, immunizations for pneumonia and in-
fectious diseases, and prompt treatment for sickle cell
crises and infections of any kind. Psychotherapy or
counseling may help patients deal with the emotional
impact of this condition.

Vitamin B , 2 deficiency anemia

A life-long regimen of B 12 shots is necessary to con-
trol symptoms of pernicious anemia. The patient may be
advised to limit physical activity until treatment restores
strength and balance.

Aplastic anemia

People who have aplastic anemia are especially sus-
ceptible to infection. Treatment for aplastic anemia may
involve blood transfusions and bone marrow transplant
to replace malfunctioning cells with healthy ones.

Anemia of chronic disease

There is no specific treatment for anemia associated
with chronic disease, but treating the underlying illness
may alleviate this condition. This type of anemia rarely
becomes severe. If it does, transfusions or hormone treat-
ments to stimulate red blood cell production may be pre-
scribed.

Hemolytic anemia

There is no specific treatment for cold-antibody he-
molytic anemia. About one-third of patients with warm-
antibody hemolytic anemia respond well to large doses
of intravenous and oral corticosteroids, which are gradu-
ally discontinued as the patient’s condition improves. Pa-
tients with this condition who do not respond to medical
therapy must have the spleen surgically removed. This
operation controls anemia in about half of the patients on
whom it is performed. Immune-system suppressants are
prescribed for patients whose surgery is not successful.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Expected results

Folic acid and iron deficiency anemia

It usually takes three to six weeks to correct folic
acid or iron deficiency anemia. Patients should continue
taking supplements for another six months to replenish
iron reserves and should have periodic blood tests to
make sure the bleeding has stopped and the anemia has
not recurred.

Pernicious anemia

Although pernicious anemia is considered incurable,
regular B 12 shots will alleviate symptoms and reverse
complications. Some symptoms will disappear almost as
soon as treatment begins.

Aplastic anemia

Aplastic anemia can sometimes be cured by a bone
marrow transplant. If the condition is due to immunosup-
pressive drugs, symptoms may disappear after the drugs
are discontinued.

Sickle cell anemia

Although sickle cell anemia cannot be cured, effec-
tive treatments enable patients with this disease to enjoy
longer, more productive lives.

Thalassemia

People with mild thalassemia (alpha thalassemia
trait or beta thalassemia minor) lead normal lives and do
not require treatment. Those with severe thalassemia
may require bone marrow transplantation. Genetic thera-
py is being investigated and may soon be available.

Hemolytic anemia

Acquired hemolytic anemia can generally be cured
when the cause is removed.

Prevention

Inherited anemia cannot be prevented. Genetic
counseling can help parents cope with questions and
concerns about passing on disease-causing genes to their
children.

Avoiding excessive use of alcohol, eating a balanced
diet that contains plenty of iron-rich foods, and taking a
daily multivitamin can help prevent anemia.

Methods of preventing specific types of anemia in-
clude:

Anemia

Angelica

KEY TERMS

Aplastic — Exhibiting incomplete or faulty devel-
opment.

Diabetes mellitus — A disorder of carbohydrate
metabolism brought on by a combination of
hereditary and environmental factors.

Hemoglobin — An iron-containing pigment of red
blood cells composed of four amino acid chains
(alpha, beta, gamma, delta) that delivers oxygen
from the lungs to the tissues of the body.

Megaloblast — A large erythroblast (a red marrow
cell that synthesizes hemoglobin).

• Avoiding lengthy exposure to industrial chemicals and
drugs known to cause aplastic anemia.

•Not taking medication that has triggered hemolytic
anemia and not eating foods that have caused hemoly-
sis (breakdown of red blood cells).

• Receiving regular B 12 shots to prevent pernicious ane-
mia resulting from gastritis or stomach surgery.

Resources

BOOKS

Fauci, Anthony S. et al., eds. Harrison's Principles of Internal
Medicine. New York: McGraw-Hill, 1998.

Tierney, Lawrence M., Jr. Current Medical Diagnosis & Treat-
ment, 1998. Stamford, Conn.: Appleton & Lange, 1998.

Paula Ford-Martin

Angelica

Description

Angelica is a genus of plants in the parsley family
used in both Western healing and traditional Chinese
medicine. Usually the dried root is used medicinally.
The most common angelica used in Western healing is
the European species, Angelica archangelica. Occasion-
ally the North American species, A. atropurpurea, is
used in the same way as A. archangelica. Other names
for Western Angelica are European angelica, garden an-
gelica, purple angelica, Alexander’s archangel, master-
wort, wild angelica, and wild celery.

Western angelica grows to a height of about 4.5 ft
(1.5 m) in dappled sun. It has white to yellow flowers,

and very large three-part leaves. The root is long and fi-
brous and is poisonous if used fresh. The plant has a
strong, tangy odor and taste.

There are at least 10 species of angelica used in tra-
ditional Chinese medicine. The most frequently used
species is A. sinensis , which in Chinese is called dong
quai (alternate spellings are dang gui , tang kwei, and tang
gui). Other Chinese species include A. pubescens, called
in Chinese du Into, and A. dahurica , called in Chinese bai
zhi. The descriptions of the medicinal uses of Chinese an-
gelica in this article refer only to A. sinensis or dong quai.

Chinese angelica is a perennial that grows to a
height of 3 ft ( 1 m) in moist, fertile soil at high altitudes
in China, Korea, and Japan. It has a purple stem and um-
brella-like clusters of flowers. The root is used medici-
nally and as a spice.

The species of angelica used in Western healing
have different properties than those used in Eastern med-
icine, so they will be treated separately here. The reader
should not assume that any properties or benefits as-
cribed to Western angelica also apply to Chinese angeli-
ca or vice versa.

General use

Western angelica

Western angelica, or A. archangelica , is said to have
been named after an angel who revealed the herb to a Eu-
ropean monk as a curative. It has a long history of folk use
in Europe, Russia, and among Native American tribes.

The leaves of angelica are prepared as a tincture or
tea and used to treat coughs, colds, bronchitis, and other
respiratory complaints. They are considered gentler in
action than preparations made from the root. The root is
the most medically active part of the plant. It is used as
an appetite stimulant and to treat problems of the diges-
tive system and liver. It is said to relieve abdominal
bloating and gas, indigestion, and heartburn.

Angelica will induce sweating and is also used to
treat conditions such as arthritis and rheumatism. In addi-
tion, it is used as a diuretic. Externally, angelica is applied
as an ointment to treat lice and some skin disorders.

In addition to medicinal use, an essential oil derived
from the plant is used in making perfumes and as a food
flavoring. Oil from the seeds imparts the distinctive fla-
vor to the Benedictine liqueur. Sometimes candied leaves
and stalks are used as sweets.

Despite its widespread folk use, angelica can present
some serious health hazards. The root is poisonous when
fresh and must be dried thoroughly before use. All members
of the genus contain compounds called furocoumarins that
can cause a person exposed to the sun or other source of ul-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

traviolet rays to develop severe sunburn and/or rash (photo-
dermis). In addition, in animal studies, furocoumarins have
been found to cause cancer and cell damage even without
exposure to light. The essential oil contains safrole, the can-
cer-causing substance that caused the United States Food
and Drug Administration (FDA) to ban the herb sassafras.

Despite these health concerns, the German Federal
Health Agency’s Commission E, established in 1978 to
independently review and evaluate scientific literature
and case studies pertaining to herb and plant medica-
tions, has approved preparations containing angelica root
as a treatment for bloating and as an appetite stimulant.

Chinese angelica

Chinese angelica, or dong quai , is considered in tra-
ditional Chinese medicine (TCM) to have a warm nature
and a sweet, acrid, and bitter taste. The main use of an-
gelica in TCM is to regulate the female reproductive or-
gans and treat irregularities of the menstrual cycle, espe-
cially deficient bleeding. Chinese herbalists also use this
herb to treat irregular periods, menstrual cramps, and in-
fertility. The root is one component of Four Things
Soup, a widely used woman's tonic in China.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Dong quai is one of the best known herbs in China,
and is one of the traditional Chinese herbs that is in-
creasingly familiar in the West. In addition to treating
women’s complaints, Chinese angelica is used in general
blood tonics to improve conditions such as anemia. Be-
cause angelica is considered to be a warming herb, it is
also used to aid circulation and digestion. Other uses are
to treat headache, constipation, rheumatism, high blood
pressure, and ulcers.

Dong quai contains several active compounds called
coumarins. These compounds are well documented as
agents that dilate (open up) the blood vessels, stimulate
the central nervous system, and help control spasms. It is
likely that these compounds do act on the uterus, support-
ing the use of dong quai for some women’s problems.

Animal and test-tube studies indicated that dong
quai may combat allergies by altering the immune sys-
tem response. Other animal studies suggest that the herb
is a mild diuretic.

Unfortunately, dong quai, like Western angelica,
contains compounds that can cause a person exposed to
the sun or other source of ultraviolet rays to develop se-
vere sunburn and/or rash. These problems become more
severe when using the concentrated essential oil or puri-

Angelica

Angina

KEY TERMS

Decoction — Decoctions are made by boiling an
herb, then straining the solid material out for the
resulting liquid.

Diuretic — A diuretic is any substance that increas-
es the production of urine.

Tincture — An alcohol-based extract prepared by
soaking plant parts.

fied forms of the herb. The essential oil also contains saf-
role, a known carcinogen.

Preparations

Angelica root is harvested in the fall, then dried for
future use. The leaves of Western angelica can be made
into a tea ( 1 teaspoon powdered leaves to one cup of boil-
ing water steeped up to 20 minutes), a tincture, or a cream
for external use. The root can be made into a tincture or a
decoction. The essential oil can be combined with other
oils for external use as a massage oil for arthritis.

Dong quai is used in many common Chinese formu-
las and as a component of many medicinal soups.

Precautions

Children or pregnant women should not take angelica.
In light of its potential for causing health problems, com-
plete avoidance of the herb may be considered desirable.

Side effects

In addition to increasing the risk of photodermis, an-
gelica is considered to be a mild laxative and may cause

mild diarrhea.

Interactions

No studies exist on interactions between angelica
and conventional pharmaceuticals. Given the history of
its long use in traditional Chinese medicine, it appears
unlikely that there are any significant interactions with
other commonly used Chinese herbs.

Resources

BOOKS

Chevallier. Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.

PDR for Herbal Medicines. Montvale, New Jersey: Medical
Economics Company, 1999.

Molony, David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.

Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.

Teegaurden. Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.

Weiner, Michael and Janet Weiner. Herbs that Heat. Mill Val-
ley, CA: Quantum Books, 1999.

ORGANIZATIONS

American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.

OTHER

Plants for the Future “Angelica archangelica.” <www.metalab.
unc.edu.>

Plants for the Future "Angelica sinensis.” <www.metalab.unc.
edu.>

Tish Davidson

Angelica archangelica see Angelica
Angelica sinensis see Dong quai

Angina

Definition

Angina is pain, discomfort, or pressure in the chest
that is caused by ischemia, an insufficient supply of oxy-
gen-rich blood to the heart muscle. It is sometimes also
characterized by a feeling of choking, suffocation, or crash-
ing heaviness. This condition is also called angina pectoris.

Description

Often described as a muscle spasm and choking sen-
sation, the term angina is used primarily to describe chest
(thoracic) pain caused by insufficient oxygen to the heart
muscle. An episode of angina is not an actual heart attack,
but rather pain that results when the heart muscle tem-
porarily receives too little blood. This temporary condition
may be the result of demanding activities such as exercise
and does not necessarily indicate that the heart muscle is
experiencing permanent damage. In fact, episodes of angi-
na seldom cause permanent damage to heart muscle.

Angina can be subdivided into two categories: angi-
na of effort and variant angina.

Angina of effort

Angina of effort is a common disorder caused by the
narrowing of the arteries (a condition called atherosclero-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

sis) that supply oxygen-rich blood to the heart muscle. In
the case of angina of effort, the coronary arteries can pro-
vide the heart muscle (myocardium) adequate blood dur-
ing rest but not during periods of exercise, stress, or ex-
citement. The resulting pain is relieved by resting or by
administering nitroglycerin, a medication that relaxes the
heart muscle, opens up the coronary blood vessels, and
lowers the blood pressure — all of which reduce the heart’s
need for oxygen. Patients with angina of effort have an in-
creased risk of heart attack (myocardial infarction).

Variant angina

Variant angina is uncommon and occurs indepen-
dently of atherosclerosis, which may incidentally be pre-
sent. Variant angina occurs at rest and is not related to
excessive work by the heart muscle. Research indicates
that variant angina is caused by coronary artery muscle
spasm that does not last long enough or is not intense
enough to cause an actual heart attack.

Causes & symptoms

Angina is usually caused by an underlying obstruc-
tion to the coronary artery due to atherosclerosis. In
some cases, it is caused by spasm that occurs naturally or
as a result of ingesting cocaine. In rare cases, angina is
caused by a coronary embolism or by a disease other
than atherosclerosis that places demands on the heart.

Most episodes of angina are brought on by physical
exertion, when the heart needs more oxygen than is
available from the blood nourishing the heart. Emotional
stress, extreme temperatures, heavy meals, cigarette
smoking, and alcohol can also cause or contribute to an
episode of angina.

Angina causes a pressing pain or sensation of heavi-
ness, usually in the chest area under the breast bone
(sternum). It is occasionally experienced in the shoulder,
arm, neck, or jaw regions. In most cases, the symptoms
are relieved within a few minutes by resting or by taking
prescribed angina medications.

Diagnosis

Physicians can usually diagnose angina based on the
patient’s symptoms and the precipitating factors. Howev-
er, other diagnostic testing is often required to confirm or
rule out angina, or to determine the severity of the under-
lying heart disease.

Electrocardiogram (ECG)

An electrocardiogram is a test that records electrical
impulses from the heart. The resulting graph of electrical

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

activity can show if the heart muscle isn’t functioning
properly as a result of a lack of oxygen. Electrocardio-
grams are also useful in investigating other possible ab-
normal features of the heart, such as arrhythmia (irregu-
lar heartbeat).

Stress test

For many individuals with angina, the results of an
electrocardiogram while at rest will not show any abnor-
malities. Because the symptoms of angina occur during
stress, the heart’s function may need to be evaluated
under the physical stress of exercise. The stress test
records information from the electrocardiogram before,
during, and after exercise in search of stress-related ab-
normalities. Blood pressure is also measured during the
stress test and symptoms are noted. In some cases a more
involved and complex stress test (for example, thallium
scanning) is used to picture the blood flow in the heart
muscle during the most intense exercise and after rest.

Angiogram

The angiogram, which is a series of x rays of the
coronary artery, has been noted as the most accurate diag-
nostic test to indicate the presence and extent of coronary
disease. In this procedure, a long, thin, flexible tube
(catheter) is inserted into an artery located in the forearm
or groin. This catheter is passed further through the artery
into one of the two major coronary arteries. A dye is in-
jected through the catheter to make the heart, arteries, and
blood flow clearer on the x ray. A fluoroscopic film, or
series of “moving” x rays, shows the blood flowing
through the coronary arteries. This will reveal any possi-
ble narrowing that can cause a decrease in blood flow to
the heart muscle and associated symptoms of angina.

Treatment

Controlling existing factors that place the individual at
risk is the first step in addressing artery disease that causes
angina. These risk factors include cigarette smoking, high
blood pressure, high cholesterol levels, and obesity.

Once the angina has subsided, the cause should be
determined and treated. Atherosclerosis, a major associ-
ated cause, requires diet and lifestyle adjustments, pri-
marily including regular exercise, reduction of dietary
sugar and saturated fats, and increase of dietary fiber.

In recent years, several specific cholesterol-lowering
treatments have gained the attention and interest of the
public. One of the most recent popular treatments is garlic
( Allium sativum). Some studies have shown that garlic can
reduce total cholesterol by about 10% and LDL (bad) cho-
lesterol by 15%, and can raise HDL (good) cholesterol by

Angina

10%. Other studies have not shown significant benefit. Al-
though its effect on cholesterol is not as great as the effect
achieved by medications, garlic may help in relatively
mild cases of high cholesterol, without causing the side ef-
fects associated with cholesterol-reducing drugs.

A 1999 study published in the American Journal of
Clinical Nutrition found that red yeast extract can signifi-
cantly reduce cholesterol when it’s taken in conjunction
with a low-fat diet. Red yeast extract, available in the Unit-
ed States under the trade name Cholestin, has been used in
Chinese medicine to treat heart maladies for hundreds of
years. The effectiveness of the extract depends on the pa-
tient’s cholesterol level and medical history, so individuals
should consult with their healthcare professionals before
taking the supplement. Additional herbal remedies that
may help lower cholesterol include oats ( Avena sativa), al-
falfa ( Medicago sativa ), fenugreek (Trigonella foenum-
graecum ), Korean ginseng ( Panax ginseng), myrrh
(Commiphora molmol ), and turmeric (Curcuma longa).

Yarrow (Achillea millefolium ), linden (Tilia eu-
ropaea), and hawthorn (Crataegus spp.) are sometimes
recommended for controlling high blood pressure, a risk
factor for heart disease. In particular, hawthorn extract
appears to benefit the aging heart. A 2001 report of a Eu-
ropean study reported that patients using hawthorn ex-
tract showed improvements in exercise tolerance, fa-
tigue, and shortness of breath.

Tea (Camellia sinensis) — especially green tea — is
high in antioxidants, and studies have shown that it may
help prevent atherosclerosis. Other antioxidants, includ-
ing vitamin A (beta carotene), vitamin C, vitamin E,
and selenium, can also limit the damage to the walls of
blood vessels by oxidation, which may be lead to the for-
mation of atherosclerotic plaque.

Vitamin and mineral supplements that reduce, re-
verse, or protect against coronary artery disease include
chromium, calcium and magnesium, B-complex vita-
mins, L-carnitine, and zinc. Yoga and other bodywork,
massage, aromatherapy, and music therapy may also
help reduce angina symptoms by promoting relaxation
and stress reduction.

Traditional Chinese medicine may recommend
herbal remedies (such as a ginseng and aconite combina-
tion), massage, acupuncture, and dietary modification.
Exercise and a healthy diet, including cold-water fish as a
source of essential fatty acids, are important components
of a regimen to prevent angina and heart disease.

Allopathic treatment

Angina is often controlled by medication, most
commonly with nitroglycerin. This drug relieves symp-

toms of angina by increasing the diameter of the blood
vessels that carry blood to the heart muscle. Nitroglyc-
erin is taken whenever discomfort occurs or is expected.
It may be taken sublingually, by placing the tablet under
the tongue. Or it may be administered transdermally, by
placing a medicated patch directly on the skin.

In addition, beta-blockers or calcium channel block-
ers may be prescribed to decrease the heart’s rate and
workload. In late 2001, a study reported that the drug
Nicorandil had become the first to demonstrate a reduc-
tion in risk of angina and to improve symptoms in patients
with chronic stable angina. Guidelines released late in
2000 promoted use of lopidogrel to help prevent recurring
events. A study group that used clopidogrel and aspirin
showed a significant decrease in cardiovascular death,
nonfatal heart attack, and stroke compared to patients in a
control group that received a placebo and aspirin.

When conservative treatments are not effective in
reducing angina pain and the risk of heart attack remains
high, physicians may recommend angioplasty or surgery.
In coronary artery bypass surgery, a blood vessel (often a
long vein surgically removed from the leg) is grafted
onto the blocked artery to bypass the blocked portion.
This newly formed pathway allows blood to flow ade-
quately to the heart muscle.

Another procedure used to improve blood flow to
the heart is percutaneous tranluminal coronary angio-
plasty, usually called coronary or balloon angioplasty. In
this procedure, the physician inserts a catheter with a
tiny balloon at the end into a forearm or groin artery. The
catheter is then threaded up into the coronary arteries,
and the balloon is inflated to open the vessel in narrowed
sections. Other techniques to open clogged arteries are
under development and in limited use, including the use
of lasers, stents, and other surgical devices.

Expected results

The prognosis for a patient with angina depends on
the general health of the individual as well as on the ori-
gin, type, and severity of the condition. A person can im-
prove his or her prognosis by seeking prompt medical at-
tention and learning the pattern of his or her angina, such
as what causes the attacks, what they feel like, how long
episodes usually last, and whether medication relieves
the attacks. Medical help should be sought immediately
if patterns of the symptoms change significantly or if
symptoms resemble those of a heart attack.

Prevention

In most cases, the best prevention involves changing
habits to avoid bringing on attacks of angina. A heart-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Atherosclerosis — Progressive narrowing and hard-
ening of the arteries caused by the buildup of
plaque on the artery walls, which results in re-
stricted blood flow.

Ischemia — Decreased blood supply to an organ or
body part, often resulting in pain.

Myocardial infarction — A blockage of a coronary
artery that cuts off the blood supply to part of the
heart. In most cases, the blockage is caused by
fatty deposits.

Myocardium — The thick middle layer of the heart
that forms the bulk of the heart wall and contracts
as the organ beats.

healthy lifestyle includes eating right, exercising regularly,
maintaining an appropriate weight, not smoking, drinking
in moderation, controlling hypertension, and managing
stress. Most healthcare professionals can provide valuable
advice on proper diet, weight control, smoking cessation,
blood cholesterol levels, and blood pressure.

Resources

BOOKS

American Heart Association. 2000 Heart and Stroke Statistical
Update. Dallas: American Heart Association, 1999.
Hoffmann, David. The Complete Illustrated Herbal. New York:
Barnes & Noble, 1999.

PERIODICALS

Jancin, Bruce. “Nicorandil Relieves Stable Angina, Cuts
Events.” Interna! Medicine News 34, no. 24 (December
15,2001): 11.

Pinkowish, Mary Desmond. ‘‘Acute Coronary Syndromes: Re-
cent Treatment Advances." Patient Care 35, no. 22 (No-
vember 30, 2001): 12.

Walsh, Nancy. ‘‘Hawthorn Extract Limits CHF, Mild Heart Ail-
ments." Internal Medicine News 34. no. 19 (October 1,
2001): 9.

ORGANIZATIONS

American Heart Association. National Center. 7272 Greenville
Avenue. Dallas, Texas 75231. (800) AHA-USA1. <http://
www.americanheart.org>.

National Heart, Lung, and Blood Institute Information Center.
P.O. Box 30105. Bethesda, MD 20824. (301) 251-1222.
<http://www.nhlbi.nih.gov/health/infoctr/index.htm>.

Paula Ford-Martin
Teresa G. Odle

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Animal-assisted therapy see Pet therapy

Anise

Description

Anise, Pimpinella anisum, is a slow-growing annual
herb of the parsley family (Apiaceae, formerly Umbellif-
erae). It is related to other plants prized for their aromatic
fruits, commonly called seeds, such as dill, cumin, car-
away, and fennel. It is cultivated chiefly for its licorice-
flavored fruits, called aniseed. Although it has a licorice
flavor, anise is not related to the European plant whose
roots are the source of true licorice. It has been used as a
medicinal and fragrant plant since ancient times.

The plant reaches from 1-3 ft (0.3-1 m) in height
when cultivated, and has finely divided feather-like
bright green leaflets. The name Pimpinella (from the
Latin dipinella) refers to the pinnately divided form of
the leaves. The plant bears white to yellowish-white
flowers in compound umbels (umbrella-like clusters).
When ripe, the fruits are 0.125 in (3 mm) long and oval-
shaped with grayish-green coloring.

While the entire plant is fragrant and tastes strongly
of anise, it is the aniseed fruit that has been highly val-
ued since antiquity. Seed maturation usually occurs one
month after pollination, when the oil content in the dried
fruit is about 2.5%. Steam distillation of the crushed
aniseed yields from 2.5 to 3.5% of a fragrant, syrupy, es-
sential, or volatile, oil, of which anethole, present at
about 90%, is the principal aromatic constituent. Other
chemical constituents of the fruit are creosol, alpha-
pinene, dianethole, and photoanethole.

In addition to its medicinal properties, anise is wide-
ly used for flavoring curries, breads, soups, cakes, can-
dies, desserts, nonalcoholic beverages, and liqueurs such
as anisette. The essential oil is valuable in perfumes and
soaps and has been used in toothpastes, mouthwashes,
and skin creams.

Anise is endemic to the Middle East and Mediter-
ranean regions, including Egypt, Greece, Crete, and Turkey.
It was cultivated and used by ancient Egyptians, and used in
ancient Greece and Rome, when it was cultivated in Tus-
cany. Its use and cultivation spread to central Europe in the
Middle Ages, and today it is cultivated on a commercial
scale in warm areas such as southern Europe, Asia, India,
North Africa, Mexico, and Central and South America.

General use

The medicinal properties of anise come from the
chemicals that are present in the fruits. The anethole in

Anise

anise helps to relieve gas and settle an upset stomach. The
use of anise to season foods, especially meat and vegetable
dishes, in many parts of the world may have originated as a
digestive aid. The Romans ate aniseed cake at the end of
rich meals to prevent indigestion. The chemicals creosol
and alpha-pinene act as expectorants, loosening mucus and
making it easier to cough up. The estrogenic action of
anise is from the chemicals dianethole and photoanethole,
which act in a way similar to estrogen. The anise fruits and
the essential oil of anise contain these chemicals and can
be used medicinally. Aniseed can also be used to make an
herbal tea which can help relieve physical complaints.

As a medicinal plant, anise has been used as an antibac-
terial, an antimicrobial, an antiseptic, an antispasmodic, a
breath freshener, a carminative, a diaphoretic, a digestive
aid, a diuretic, an expectorant, a mild estrogenic, a mild
muscle relaxant, a parasiticide, a stimulant, and a stomachic.

Anise may be helpful in the following conditions:

• Anemia. Anise promotes digestion, which may help
improve anemia due to inefficient absorption of iron.

• Asthma. Essential oil of anise may be inhaled through
the nose to help ease breathing and relieve nasal con-
gestion.

• Bad breath. It can be used in mouthwash or tea to
sweeten breath.

• Bronchitis. Aniseed may be used as an expectorant and
essential oil of anise may be inhaled through the nose
to help ease breathing.

• Catarrh. Drinking aniseed tea soothes mucous mem-
branes.

• Cold. Aniseed can be used as an expectorant and drink-
ing aniseed tea soothes the throat.

• Colic. Drinking anise tea or using essential oil can alle-
viate gas.

• Cough. Can be used as an expectorant, especially for
hard, dry coughs where expectoration is difficult.

• Croup. Aniseed can be used to alleviate a persistent
cough in a child.

• Emphysema. Essential oil of anise may be inhaled
through the nose to help ease breathing and relieve
nasal congestion and tea with aniseed will soothe mu-
cous membranes.

• Gas and gas pains. Drinking aniseed tea helps relieve
gas, gas pains, and flatulence.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Menopause. Aniseed tea can help alleviate menopausal
symptoms.

• Morning sickness. Tea made from anise can help alle-
viate morning sickness during pregnancy.

• Nursing. Aniseed tea can help a nursing mother’s milk
come in.

• Sore throat. Drinking aniseed tea alleviates pain of
sore throat.

Preparations

Aniseeds. May be added to foods when cooking to
flavor and aid digestion, or may be taken whole in doses
of 1-3 tsp of dried anise seeds per day.

Tea. One tsp of crushed aniseeds can be steeped in a
cup of hot water, then combined with fennel and car-
away to help relieve gas and gas pains. To help relieve a
cough, coltsfoot, marsh mallow, hyssop, and licorice
can be added to the tea. Infants should only receive 1 tsp
of boiled, prepared tea.

Essential oil. Preparations of essential oil of anise
can be used for inhalation. The essential oil may be
taken orally at a dose of 0.01 oz (0.3 g) per day. In addi-
tion, the liqueur anisette, which contains anise essential
oil, may be administered in hot water to help relieve
problems in the bronchial tubes, such as bronchitis and
spasmodic asthma. One to three drops of essential oil ad-
ministered on sugar may help relieve colic.

Precautions

Persons allergic to anise or anethole, its main ingre-
dient, should avoid using aniseed or its essential oil. It is
also possible to develop an allergic sensitivity to anise.
Care should be taken to monitor the quantity of aniseed
oil given to infants. A 2002 report noted an infant
brought to the emergency department with seizures as a
result of multiple doses of aniseed oil tea.

Side effects

Although anise is generally considered safe, the side
effects of its estrogenic property have not been fully
studied. Anise oil may induce nausea, vomiting,
seizures, and pulmonary edema if it is ingested in suffi-
cient quantities. Also, contact of the skin with the con-
centrated oil can cause irritation.

It is important to note that Japanese Star Anise is not
the same herb — it is poisonous.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Anemia — Condition in which the blood is defi-
cient in red blood cells, in hemoglobin, or in total
volume.

Antiseptic — A substance that checks the growth or
action of microorganisms especially in or on liv-
ing tissue.

Antispasmodic — A substance capable of preven-
tion or relieving spasms or convulsions.

Carminative — A substance that expels gas from
the alimentary canal to relieve colic or griping.

Catarrh — Inflammation of a mucous membrane,
especially of the nose and air passages.

Diaphoretic — A substance that increases perspira-
tion.

Diuretic — A substance that increases the flow of
urine.

Estrogenic — A substance that promotes estrus, the
state in which a woman is capable of conceiving.
Expectorant — A substance that promotes the dis-
charge or expulsion of mucus.

Parasiticide — A substance destructive to parasites.
Stomachic — A stimulant or tonic for the stomach.

Interactions

No interactions have been reported.

Resources

BOOKS

Foster, Gertrude B. and Rosemary F. Louden. Park’s Success
with Herbs. Greenwood, S. C.: G. W. Park Seed Co., 1980.

Grieve, M. A Modern Herbal: The Medicinal, Culinary, Cos-
metic and Economic Properties, Cultivation and Folk-lore
of Herbs, Grasses, Fungi, Shrubs, & Trees with All Their
Modern Scientific Uses. New York: Harcourt, Brace and
Co., 1931.

Reader’s Digest Editors. Magic and Medicine of Plants. Pleas-
antville, N.Y.: Reader’s Digest Association, 1986.

Simon, James E., Alena F. Chadwick and Lyle E. Craker.
Herbs: An Indexed Bibliography, 1971-1980: The Scien-
tific Literature on Selected Herbs, and Aromatic and Med-
icinal Plants of the Temperate Zone. Hamden, Conn.: Ar-
chon Books, 1984.

PERIODICALS

Tuckler, V., et al. “Seizure in an Infant from Aniseed Oil Toxic-
ity.” Clinical Toxicology (August 2002): 689.

Anise

Ankylosing spondylitis

OTHER

Herb Society of America, http://www.herbsociety.org/anise.htm/
(July 12, 2000).

“Herbs." Department of Horticulture, Pennsylvania State Uni-
versity. http://garden.cas.psu.edu/vegcrops/herbs/Pimpinel
laanisum.html/ (July 12, 2000).

One Planet, http://www.oneplanetnatural.com/anise.htm/ (July

12, 2000).

“Pimpinella anisurn.” http://webmd.lycos.com/content/article/
1677.57580/ (July 12,2000).

Melissa C. McDade
Teresa G. Odle

Ankylosing spondylitis

Definition

Ankylosing spondylitis (AS) is a systemic disorder that
refers to inflammation of the joints in the spine. AS is the
primary disease in an entire group of conditions known as
seronegative spondylarthropathies. It is also known as
rheumatoid spondylitis or Marie-Striimpell disease (among
other names). AS is an autoimmune disease, as are most
forms of arthritis. By definition, other joints, in addition to
the spine, can also be affected, including the shoulders,
hips, knees, and feet. Tissues in the eye can also be affected.

Description

A form of arthritis, AS is characterized by chronic
inflammation, causing pain and stiffness of the back,
progressing to the chest and neck. Eventually, the whole
back may become curved and inflexible if the bones
fuse, which is known as “bamboo spine.” Other condi-
tions associated with AS include reactive arthritis, psori-
atic arthritis, spondylitis of inflammatory bowel dis-
ease, and undifferentiated spondy arthropathy. AS may
involve multiple organs, such as the:

• eye (causing an inflammation of the iris, or iritis)

• heart (causing aortic valve disease)

• lungs

• skin (causing a scaly skin condition, or psoriasis)

• gastrointestinal tract (causing inflammation within the
small intestine, called ileitis, or inflammation of the
large intestine, called colitis).

Less than 1% of the population has AS; however,
20% of AS sufferers have a relative with the disorder.

Causes & symptoms

Genetics, in the form of a gene named HLA-B27,
can play an important role in the disease, but the precise

cause of AS remains unknown. According to information
from the Spondylitis Association of America, HLA-B27
is a perfectly normal gene found in 8% of the general
population. Generally speaking, no more than 2% of
people born with this gene will eventually get spondyli-
tis. The gene itself does not cause spondylitis, but people
with HLA-B27 are more susceptible to getting spondyli-
tis. To date, 15 subtypes of HLA-B27 have been identi-
fied. The most common subtypes in the United States
being B27.05, and then after that B27.02. The way in
which HLA-B27 interacts with some other proteins
seems to be very important to the cause of AS, but fur-
ther research must be conducted to find out exactly how.
According to information published in 1997 from The
Arthritis Cure, by Dr. Jason Theodosakis, M.D., M.S.,
M. P. H., and others, research was being conducted re-
garding the possibility that a certain type of infection
could be the trigger for the onset of AS.

Symptoms of AS include:

• low back and hip pain and stiffness

• duration of symptoms longer than three months

• difficulty expanding the chest

• early morning stiffness improved by a warm shower or
light exercise

• pain in the neck, shoulders, knees, and ankles

• low-grade fever

• fatigue

• weight loss

AS occurs most often in males between 16 and 35
years of age. Initial symptoms are uncommon after the
age of 30, although the diagnosis may not be established
until after that age. The incidence of AS in African
Americans is about 25% of incidence among Cau-
casians, but is rarely seen in that population.

Some naturopathic healers link the cause of AS to
its autoimmune origins in food allergies and abnormal
bowel function, sometimes referred to as “leaky gut”
syndrome. According to this theory, food allergies com-
bine with the leaky gut and, according to the Healing-
WithNutrition website, from a 1986 article in the Britain
Journal of Rheumatology, “..result in the increased circu-
lation of gut-derived antigens into other areas of the
body. The body produces antibody-antigen complexes
(immune complexes) characteristic of RA (rheumatoid
arthritis) to battle these gut-derived foreign antigens;
but these antibody-antigens are thought to also cross-
react with antigens in the joint tissues. In other words,
the antibodies formed to attack the (leaky gut) microbes
also cross-react and attack joint collagen.”

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Diagnosis

Doctors usually diagnose the disease simply by the
patient’s report of pain and stiffness. Doctors also review
spinal and pelvic x rays since involvement of the hip and
pelvic joints is common and may be the first abnormality
seen on the x ray. The doctor might also order a blood
test to determine the presence of HLA-B27 antigen if
the x rays have not clearly determined the diagnosis. If
the gene is present, it could facilitate the accuracy of the
possible AS diagnosis. When a diagnosis is made, pa-
tients may be referred to a rheumatologist, a doctor who
specializes in treating arthritis. Patients may also be re-
ferred to an orthopedic surgeon, a doctor who can surgi-
cally correct joint or bone disorders.

Treatment

To reduce inflammation, various herbal remedies,
including white willow ( Salix alba), yarrow ( Achillea
millefolium), and lobelia ( Lobelia Inflata), may be help-
ful. Acupuncture, performed by a trained professional,
has helped some patients manage their pain. Homeopath-
ic practitioners may prescribe such remedies as Bryonia
and Rhus toxicodendron for pain relief.

A key alternative treatment for AS is massage ther-
apy. Reported benefits include a decrease in pain, in-
crease in circulation, lymph flow improvement, and in-
crease in range of motion. The major benefit of this ther-
apy could be that it provides further motivation for a reg-
ular excerise program, considered the most beneficial of
all treatments for AS.

Diets of various regimens have been offered that in-
clude supplements of fatty acids and antioxidants, as
with other arthritis diets. Naturopaths and some medical
doctors have theorized that certain foods should be elim-
inated from the diet in order to alleviate symptoms. Pos-
sible problem foods include wheat, corn, milk and other
dairy products, beef, tomatoes, potatoes, and peppers.
Tobacco has also been thought to aggravate the condi-
tion. Various reports have surfaced in many books and
articles that indicate a diet high in fiber and fresh fruits
and vegetables — minus those listed above — and low in
sugar, meat, refined carbohydrates, and animal fats
might help in the treatment of the symptoms, particularly
with pain or swelling.

Allopathic treatment

Nonsteroidal anti-inflammatory drugs (NSAIDs),
like naproxen (Naprosyn) or indomethacin (Indocin) are
used to relieve pain and stiffness. In severe cases, sul-
fasalazine (Azulfidine), another drug to reduce inflam-
mation, or methotrexate (Rheumatrex), an immune-sup-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

pressing drug, are recommended. In cases where chronic
therapy is needed, potential drug side effects must be
taken into consideration. Corticosteroid drugs are effec-
tive in relieving symptoms, but are usually reserved for
severe cases that do not improve when NSAIDs are used.
To avoid potential side effects, treatment with corticos-
teroids is usually limited to a short amount of time with a
gradual weaning from the drug.

In April 2002, a study published revealed that a drug
already approved for patients with rheumatoid arthritis
was successful in helping most AS patients as well. In-
fliximab helped alleviate pain and improved functioning
in more than 80 % of patients in a clinical trial. The drug
worked rapidly and reduced disease activity by more
than half in about 50% of patients. Some serious side ef-
fects did occur, so researchers continued to test the drug
and seek Food and Drug Administration (FDA) approval
for Infliximab for AS patients. In the same year, scien-
tists were testing another drug called Etanercept that also
showed promising results in preliminary trials.

Physical therapists prescribe exercises to prevent a
stooped posture and breathing problems when the spine
starts to fuse and ribs are affected. Back braces may be
used to prevent continued deformity of the spine and
ribs. Only in severe cases of deformity is surgery per-
formed to straighten and realign the spine, or to replace
knee, shoulder, or hip joints. Because it is a major and
complicated procedure, with a potential for complica-
tions, this surgery is recommended cautiously even in se-
vere cases.

Expected results

There is no cure for AS, and the course of the dis-
ease is unpredictable. Generally, AS progresses for about
10 years, then levels off. Most patients can lead normal
lives with treatment to control symptoms. Claims that
homeopathic remedies have cured them have not been
verified.

Prevention

There is no known way to prevent AS. With twenty-
first century advances in gene therapy, the possibility ex-
ists for further determination of the factor that HLA-B27
gene plays in its manifestation, and what role it could
play in preventing it for future generations.

Resources

BOOKS

Brewer Jr., Earl J., and Kathy Cochran Angel. The Arthritis

Sourcebook. Los Angeles: Lowell House, 1993.

Swezey, Robert L. Straight Talk on Spondylitis. Spondylitis As-
sociation of America, 1994.

Ankylosing spondylitis

Anorexia nervosa

KEY TERMS

Ankylosing — When bones of a joint are fused,
stiff, or rigid.

HLA-B27 — An antigen or protein marker on cells
that may indicate ankylosing spondylitis.

Immune suppressing — Anything that reduces the
activity of the immune system.

Inflammation — A reaction of tissues to disease or
injury, often associated with pain and swelling.

Spondylitis — An inflammation of the spine.

Taurog, Joel D., and Peter E. Lipsky. "Ankylosing Spondylitis,
Reactive Arthritis, and Undifferentiated Spondy-
loarthropathy.” In Harrison's Principles of Internal Medi-
cine, edited by Anthony S. Fauci, et al. New York: Mc-
Graw-Hill, 1998.

PERIODICALS

Babayev, Marietta and Leonard Bleicher. “Low Back Pain in an
Elderly Man.” The Journal of Musculoskeletal Medicine
(April 2000).

Breban, M., B. Gombert, et al. “Thalidomide: A New Use in
Ankylosing Spondylitis?” Rheumatoid Arthritis Research
News (April 1999).

“Etanercept for ‘Rapid Improvement’ in Joint Disease.”
Chemist & Druggist (May 18, 2002): 24.

Feldtkeller, et al. “Impact of Sex on Inheritance of Ankylosing
Spondylitis.” The Lancet (March 25, 2000).

“Infliximab Highly Effective Therapy.” Immunotherapy Weekly
(May 8, 2002): 3.

Nuki, George. “Ankylosing Spondylitis, HLA B27, and Be-
yond.” The Lancet (14 March 1998). Available from http://
web2 . inf otrac . galegroup .com .

Sussman, Sharon. “Now He’s Blind.” Discover (June 1999).

Yacyshyn, Elaine A. and Marc D. Cohen. “Ankylosing
Spondylitis: Early Detection and Management.” The Jour-
nal of Musculoskeletal Medicine (December 1999).

ORGANIZATION

Arthritis Foundation. 1330 West Peachtree St., Atlanta, GA
30309. (404) 872-7100. http://www.arthritis.org.

National Institute of Arthritis and Musculoskeletal and Skin
Diseases Information Clearinghouse. 1 AMS Circle,
Bethesda, MD 29892-3675. (301) 495-4484.

Spondylitis Association of America. PO Box 5872, Sherman
Oaks, CA 91413. (800) 777-8189.

OTHER

Harris, Brian. The Ankylosing Spondylitis Site. http://www.
asweb.com/ (2000).

Healing WithNutrition. http://www.HealingWithNutrition.com/
(2000).

Matsen III, Frederick, ed. “Ankylosing Spondylitis.” http://
www.orthop.washington.edu/bonejoint/azzzzzzzl_l.html/
(December 2000).

Penn State University, Department of Orthopaedics and Reha-
bilitation, M. S. Hershey Medical Center. Adult Spin
Surgery Service, http://www.psu.edu/ortho/ (December
2000).

The Spondylitis Association of America. http://www.spondy
litis.org/ (December 2000).

Jane Spear
Teresa G. Odle

Anorexia nervosa

Definition

Anorexia nervosa is an eating disorder characterized
by unrealistic fear of weight gain, self-starvation, and
conspicuous distortion of body image. The name comes
from two Latin words that mean “nervous inability to
eat.” In females who have begun to menstruate, anorexia
nervosa is usually marked by amenorrhea, or skipping at
least three menstrual periods in a row. The fourth edition
of the Diagnostic and Statistical Manual of Mental Dis-
orders, or DSM-IV (1994), defines two subtypes of
anorexia nervosa — a restricting type, characterized by
strict dieting and exercise without binge eating — and a
binge-eating/purging type, marked by episodes of com-
pulsive eating with or without self-induced vomiting and
the use of laxatives or enemas. DSM-IV defines a binge
as a time-limited (usually under two hours) episode of
compulsive eating in which the individual consumes a
significantly larger amount of food than most people
would eat in similar circumstances.

Description

Anorexia nervosa was not officially classified as a
psychiatric disorder until the third edition of DSM in
1980. It is, however, a growing problem among adoles-
cent females and its incidence in the United States has
doubled since 1970. The rise in the number of reported
cases reflects a genuine increase in the number of per-
sons affected by the disorder, not simply earlier or more
accurate diagnosis. Estimates of the incidence of anorex-
ia range between 0.5-1% of Caucasian female adoles-
cents. Over 90% of patients diagnosed with the disorder
as of 1998 were female. It was originally thought that
only 5% of anorexics are male, but that estimate is being
revised upward. The peak age range for onset of the dis-
order is 14-18 years, although there are patients who de-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

velop anorexia as late as their 40s. In the 1970s and
1980s, anorexia was regarded as a disorder of upper- and
middle-class women, but that generalization is also
changing. More recent studies indicate that anorexia is
increasingly common among women of all races and so-
cial classes in the United States.

Anorexia nervosa is a serious public health problem
not only because of its rising incidence, but also because
it has one of the highest mortality rates of any psychi-
atric disorder. Moreover, the disorder may cause serious
long-term health complications, including congestive
heart failure, sudden death, growth retardation, dental
problems, constipation, stomach rupture, swelling of the
salivary glands, loss of kidney function, osteoporosis,
anemia and other abnormalities of the blood.

Causes & symptoms

Anorexia is a disorder that results from the interac-
tion of cultural and interpersonal as well as biological
factors. While the precise cause of the disease is not
known, it has been linked to the following:

Social influences

The rising incidence of anorexia is thought to reflect
the present idealization of thinness as a badge of upper-
class status as well as of female beauty. In addition, the
increase in cases of anorexia includes “copycat” behav-
ior, with some patients developing the disorder from imi-
tating other girls.

The onset of anorexia in adolescence is attributed to
a developmental crisis caused by girls’ changing bodies
coupled with society’s overemphasis on women’s looks.
The increasing influence of the mass media in spreading
and reinforcing gender stereotypes has also been noted.

Occupational goals

The risk of developing anorexia is higher among
adolescents preparing for careers that require attention to
weight and/or appearance. These high-risk groups in-
clude dancers, fashion models, professional athletes (in-
cluding gymnasts, skaters, long-distance runners, and
jockeys), and actresses.

Genetic and biological influences

Women whose biological mothers or sisters have the
disorder appear to be at increased risk.

Psychological factors

A number of theories have been advanced to explain
the psychological aspects of the disorder. No single ex-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

The body of a woman with anorexia. (Photograph by Biopho-
to Associates/Science Source. Photo Researchers, Inc. Repro-
duced by permission.)

planation covers all cases. Anorexia nervosa has been in-
terpreted as:

• A rejection of female sexual maturity. This rejection is
variously interpreted as a desire to remain a child, or as
a desire to resemble men as closely as possible.

• A reaction to sexual abuse or assault.

• A desire to appear as fragile and non-threatening as
possible. This hypothesis reflects the idea that female
passivity and weakness are attractive to men.

• Overemphasis on control, autonomy, and independence.
Some anorexics come from achievement-oriented fami-
lies that stress physical fitness and dieting. Many
anorexics are perfectionists and “driven” about school-
work and other matters in addition to weight control.

• Evidence of family dysfunction. In some families, a
daughter’s eating disorder serves as a distraction from
marital discord or other family tensions.

Anorexia nervosa

• Inability to interpret the body’s hunger signals accurate-
ly due to early experiences of inappropriate feeding.

Male anorexics

Although anorexia nervosa is still considered a dis-
order that largely affects women, its incidence in the
male population is rising. Less is known about the caus-
es of anorexia in males, but some risk factors are the
same as for females. These include certain occupational
goals and increasing media emphasis on external appear-
ance in men. Moreover, homosexual males are under
pressure to conform to an ideal body weight that is about
20 pounds lighter than the standard “attractive” weight
for heterosexual males.

Diagnosis

Diagnosis of anorexia nervosa is complicated by a
number of factors. One is that the disorder varies some-
what in severity from patient to patient. A second factor
is denial, which is regarded as an early sign of the disor-
der. Most anorexics deny that they are ill and are usually
brought to treatment by a family member.

Anorexia is usually diagnosed by pediatricians or
family practitioners. Anorexics develop emaciated bod-
ies, dry or yellowish skin, and abnormally low blood
pressure. There is usually a history of amenorrhea (failure
to menstruate) in females, and sometimes of abdominal
pain, constipation, or lack of energy. The patient may
feel chilly or have developed lanugo, a growth of downy
body hair. If the patient has been vomiting, she may have
eroded tooth enamel or Russell’s sign (scars on the back
of the hand). The second step in diagnosis is measure-
ment of the patient’s weight loss. DSM-IV specifies a
weight loss leading to a body weight 15% below normal,
with some allowance for body build and weight history.

The doctor will rule out other physical conditions
that can cause weight loss or vomiting after eating, in-
cluding metabolic disorders, brain tumors (especially hy-
pothalamus and pituitary gland lesions), diseases of the
digestive tract, and a condition called superior mesen-
teric artery syndrome. Persons with this condition some-
times vomit after meals because the blood supply to the
intestine is blocked. The doctor will usually order blood
tests, an electrocardiogram, urinalysis, and bone densito-
metry (bone density test) in order to exclude other dis-
eases and to assess the patient's nutritional status.

The doctor will also need to distinguish between
anorexia and other psychiatric disorders, including de-
pression, schizophrenia, social phobia, obsessive-com-
pulsive disorder, and body dysmorphic disorder. Two di-
agnostic tests that are often used are the Eating Attitudes
Test (EAT) and the Eating Disorder Inventory (EDI).

Treatment

Alternative treatments should serve as complemen-
tary to a conventional treatment program. Alternative
therapies for anorexia nervosa include diet and

nutrition, herbal therapy, hydrotherapy, aromathera-
py, Ayurveda, and mind/body medicine.

Nutritional therapy

A naturopath or nutritionist may recommend the fol-
lowing:

• avoiding sweets or baked goods

• following a nutritious and well-balanced diet (when pa-
tients resume eating normally)

• gaily multivitamin and mineral supplements

• zinc supplements. (Zinc is an important mineral needed
by the body for normal hormonal activity and enzymat-
ic function)

Herbal therapy

The following herbs may help reduce anxiety and
depression which are often associated with this disorder:

• chamomile ( Matricaria recutita)

• lemon balm (Melissa officinalis )

• linden (Tilia spp.) flowers

Aromatherapy

Essential oils of herbs such as bergamot, basil,
chamomile, clary sage and lavender may help stimulate ap-
petite, relax the body and fight depression. They can be dif-
fused into the air, inhaled, massaged or put in bath water.

Relaxation techniques

Relaxation techniques such as yoga, meditation
and t’ai chi can relax the body and release stress, anxiety
and depression.

Hypnotherapy

Hypnotherapy may help resolve unconscious is-
sues that contribute to anorexic behavior.

Other alternative treatments

Other alternative treatments that may be helpful in-
clude hydrotherapy, magnetic field therapy, acupuncture,
biofeedback, Ayurveda and Chinese herbal medicine.

Allopathic treatment

Treatment of anorexia nervosa includes both short-
term and long-term measures, and requires assessment

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

by dietitians and psychiatrists as well as medical special-
ists. Therapy is often complicated by the patient’s resis-
tance or failure to carry out treatment plan.

Hospital treatment

Hospitalization is recommended for anorexics with
any of the following characteristics:

• weight of 40% or more below normal, or weight loss
over a three-month period of more than 30 pounds

• severely disturbed metabolism

• severe binging and purging

• signs of psychosis

• severe depression or risk of suicide

• family in crisis

Hospital treatment includes individual and group
therapy as well as refeeding and monitoring of the pa-
tient's physical condition. Treatment usually requires
two to four months in the hospital. In extreme cases, hos-
pitalized patients may be force-fed through a tube insert-
ed in the nose (nasogastric tube) or by over-feeding (hy-
peralimentation techniques).

Outpatient treatment

Anorexics who are not severely malnourished can be
treated by outpatient psychotherapy. The types of treat-
ment recommended are supportive rather than insight-ori-
ented, and include behavioral approaches as well as indi-
vidual or group therapy. Family therapy is often recom-
mended when the patient’s eating disorder is closely tied
to family dysfunction. Self-help groups are often useful
in helping anorexics find social support and encourage-
ment. Psychotherapy with anorexics is a slow and diffi-
cult process; about 50% of patients continue to have seri-
ous psychiatric problems after their weight has stabilized.

Medications

Anorexics have been treated with a variety of med-
ications, including antidepressants, anti-anxiety drugs,
selective serotonin reuptake inhibitors, and lithium car-
bonate. The effectiveness of medications in treatment
regimens is still debated. However, at least one study of
Prozac showed it helped the patient maintain weight
gained while in the hospital.

Expected results

Figures for long-term recovery vary from study to
study, but the most reliable estimates are that 40-60% of
anorexics will make a good physical and social recovery,
and 75% will gain weight. The long-term mortality rate

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Amenorrhea — Absence of menstruation in a fe-
male who has begun to have menstrual periods.

Binge eating — A pattern of eating marked by
episodes of rapid consumption of large amounts
of food, usually food that is high in calories.

Body dysmorphic disorder — A psychiatric disor-
der marked by preoccupation with an imagined
physical defect.

Hyperalimentation — A method of refeeding
anorexics by infusing liquid nutrients and elec-
trolytes directly into central veins through a
catheter.

Lanugo — A soft, downy body hair that develops
on the chest and arms of anorexic women.

Purging — The use of vomiting, diuretics, or laxa-
tives to clear the stomach and intestines after a
binge.

Russell's sign — Scraped or raw areas on the pa-
tient's knuckles, caused by self-induced vomiting.

Superior mesenteric artery syndrome — A condi-
tion in which a person vomits after meals due to
blockage of the blood supply to the intestine.

for anorexia is estimated at around 10%, although some
studies give a lower figure of 3-4%. The most frequent
causes of death associated with anorexia are starvation,
electrolyte imbalance, heart failure, and suicide.

Prevention

Short of major long-term changes in the larger soci-
ety, the best strategy for prevention of anorexia is the
cultivation of healthy attitudes toward food, weight con-
trol, and beauty (or body image) within families.

Resources

BOOKS

"Anorexia Nervosa.” In Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition. Washington, DC: The
American Psychiatric Association, 1994.

Baron, Robert B. “Nutrition.” In Current Medical Diagnosis &
Treatment edited by Lawrence M. Tierney, Jr., et al. Stam-
ford, CT: Appleton & Lange, 1998.

The Burton Goldberg Group. Alternative Medicine: The Defin-
itive Guide. Fife, WA: Future Medicine Publishing, 1995.
Cassell, Dana K., with Felix E. F. Larocca. The Encyclopedia
of Obesity and Eating Disorders. New York: Facts on File,
Inc., 1994.

Anorexia nervosa

Anthroposophical medicine

Herzog, David B. “Eating Disorders.” In The New Harvard
Guide to Psychiatry. Edited by Armand M. Nicholi, Jr.,
Cambridge, MA, and London, UK: The Belknap Press of
Harvard University Press, 1988.

Kaplan, David W., and Kathleen A. Mammel. “Adolescence.”
In Current Pediatric Diagnosis & Treatment. Edited by
William W. Hay, Jr., et al. Stamford, CT: Appleton &
Lange, 1997.

Mitchell, James E. “Anorexia Nervosa: Medical and Physiolog-
ical Aspects.” In Handbook of Eating Disorders. Edited
by Kelly D. Brownell and John P. Foreyt. New York: Basic
Books, Inc., 1986.

The Medical Advisor: The Complete Guide to Alternative &
Conventional Treatments. Richmond, VA: TimeLife Edu-
cation, 1997.

“Physical Conditions in Adolescence: Anorexia Nervosa.” In
The Merck Manual of Diagnosis and Therapy, vol. II.
Edited by Robert Berkow, et al. Rahway, NJ: Merck Re-
search Laboratories, 1992.

Pipher, Mary. Reviving Ophelia: Saving the Selves of Adoles-
cent Girls. New York: Ballantine Books, 1994.

ORGANIZATIONS

American Anorexia/Bulimia Association. 418 East 76th St.,
New York, NY 10021. (212) 734-1114.

National Institute of Mental Health Eating Disorders Program,
Building 10, Room 3S231. 9000 Rockville Pike, Bethes-
da, MD 20892. (301) 496-1891.

OTHER

Eating Disorders Home Page, <http://ccwf.cc. utexas.edu:80/
jackson/UTHealth/eating.html.>

Mai Tran

Anthroposophical medicine

Definition

Anthroposophical medicine (AM), or anthroposophi-
cally extended medicine, is a system of healing based on
the spiritual science that was developed by Rudolph Steiner.

Origins

Rudolph Steiner (1861-1925) was a philosopher and
teacher who founded anthroposophy ( anthropos meaning
human and sophy meaning wisdom), which is a worldwide
spiritual movement that seeks to apply a scientific ap-
proach to spiritual perception. Steiner, from Austria, be-
lieved that everyone has spiritual powers that can be acti-
vated by exercises in mental concentration and
meditation. During his lifetime, he was an active teacher,
attracting many followers to his spiritual ideas. Steiner

founded several schools, wrote nearly 30 books, and gave
more than 6,000 lectures around the world on subjects in-
cluding education, medicine, agriculture, social issues, sci-
ence and art. His ideas have remained influential. The Wal-
dorf school system, which he began, educates thousands of
young people each year. Many health food stores carry
products produced by Steiner’s system of agriculture called
biodynamic farming, which considers the health and purity
of the soil, water, and air to be of central importance.

Anthroposophical medicine is based on Steiner’s
concept that spiritual awareness is the foundation of in-
dividual health and of the health of society. Steiner be-
lieved that many of the oldest systems of healing, such as
traditional Chinese medicine. Ayurvedic medicine,
and Tibetan medicine, were based on a spiritual percep-
tion of the world that modern science has lost. Steiner
wanted medicine to get back in touch with spirituality,
and at the same time keep and use wisely the gains that
science and technology have made. Thus, conventional
medicine needed to be extended beyond physical science
to include a holistic spiritual science.

Steiner formally began application of his philosophy
in a series of 20 lectures in the early spring of 1920 to
the medical community of a town in Switzerland. It was
the first such course for physicians and medical students.
He and Dutch medical doctor Ita Wegman co-authored a
foundational work for physicians wanting to expand
their practice according to anthroposophic principles.

Anthroposophical medicine is still in its early stages.
Steiner believed that it would take many years for his med-
ical ideas to be fully applied. There are thousands of anthro-
posophical doctors and researchers practicing in Europe,
where the main school was founded. In America, practition-
ers can be found in several large cities, but the overall num-
ber of anthroposophical physicians is very small.

Benefits

Anthroposophical medicine can be used to treat any
health condition. It is particularly recommended for pre-
ventive care, infections, inflammatory conditions such
as arthritis, and the treatment of cancer and chronic de-
generative diseases associated with aging. It is also rec-
ommended for pediatric (child) care, with its avoidance
of toxic drugs, and is beneficial for children’s conditions
such as attention-deficit hyperactivity disorder
(ADHD) and developmental problems.

Description

The anthroposophical concept of the body

Anthroposophical physicians have a different view
of the body and health than the conventional scientific

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

model. Human beings are made up of four levels (“four-
foldness”) of being. The first level is the physical body.
The second level is the life or etheric body, which corre-
sponds to the Chinese idea of chi and the Ayurvedic idea
of prana. The third level is the soul, or astral body, and
the fourth level is the spirit. AM doctors believe that all
levels of being influence a patient’s health.

The physical body is made up of a three-fold sys-
tem, including the “sense-nerve” system that comprises
the head and nervous system, supporting the mind and
the thinking process. Second is the “metabolic-limb”
system that includes the digestive system for elimina-
tion, energetic metabolism, and voluntary movement
processes, all supporting aspects of human behavior that
express the will. Finally, the rhythmic system that in-
cludes the heart and lungs in the chest, is responsible for
balancing the head and digestive systems. According to
AM, these systems tend to oppose each other in func-
tioning and characteristics, similar to the Chinese con-
cept of yin and yang. For instance, the digestive system
is associated with heat and helps to dissolve elements in
the body, while the head system is associated with cool-
ing and helps in the formation of elements in the body.
Illness is caused when the systems of the body become
out of balance. AM involves a broad understanding of
the three bodily systems, and the illnesses associated
with each system and its imbalance. This model provides
practitioners a means for therapeutic insight now recog-
nized as mind-body relationships in health and disease.

In anthroposophical medicine, illness is considered a
significant event in a person’s life, and not just a chance
occurrence. One role of the doctor is to understand, and
help the patient understand, the significance of the illness
on all levels of being. Conventional medicine tends to
suppress illness, using drugs to block the symptoms. AM
doctors believe that true healing must first bring an illness
out in order to heal it, and that healing requires change
and development in the patient on several levels.

AM also asserts, as did the early healer Paracelsus,
that every illness has a cure that can be found in nature.
Paracelsus is the pseudonym for a Swiss-born alchemist
and physician who lived from 1493-1541. Nature and
the human body are made up of the plant, animal, and
mineral kingdoms, and thus AM doctors use medicines
that are made from plants, animals (usually in the form
of organ extracts), and minerals. AM remedies are usual-
ly given in homeopathic doses, which are very diluted,
non-toxic solutions.

Treatment by an anthroposophical physician

All anthroposophical physicians are conventionally
trained M.D.s, as Steiner believed that conventional train-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ing was a necessary first step. However, a visit to an an-
throposophical physician may be different than a visit to a
regular doctor. Anthroposophical doctors, first of all, tend
to spend much more time with their patients, particularly
during the initial visit. Every patient is considered unique,
and AM doctors use the first visit to get a broad under-
standing of patients and their medical histories. To diag-
nose illnesses, AM doctors may use modern diagnostic
tools, but also rely on intuition and an understanding of the
patient. Part of training of AM doctors involves improving
their powers of perception in order to understand illnesses.
Diagnosis is considered a very important process; Steiner
believed that if the diagnosis of a problem is done correct-
ly, then the therapeutic (healing) work is much easier. After
a problem is thoroughly diagnosed, treatment will be rec-
ommended. AM doctors attempt to treat a patient on all
four levels of being. For the physical body, remedies will
be prescribed. There are hundreds of uniquely formulated
medications, similar to homeopathies, as well as botanical
medicines. AM doctors try to minimize the use of antibi-
otics, drugs, and vaccinations.

Anthroposophical medicine also uses allied thera-
pies, which are additional therapies that Steiner recom-
mended to heal patients on other levels than the physical.
These include massage therapy and a movement thera-
py called eurythmy. Eurythmy is a system of movements
designed to help patients give expression to inner spiritu-
al movements. Psychotherapy may also be recommend-
ed to help heal some conditions. AM doctors may apply
allied therapies themselves, or refer patients to other
healers. The length of treatment with AM depends on the
patient and condition. The cost of treatment varies with
the practitioner, and is comparable to treatment by con-
ventional M.D.s. AM medications are less expensive
than conventional drugs. Because AM practitioners are
trained medical doctors, insurance policies often cover
their fees, although consumers should be aware of their
policy restrictions.

Preparations

AM doctors may give new patients packages of ma-
terials before treatment, which include thorough ques-
tionnaires and explanations of AM. Anthroposophical
physicians encourage patients to prepare for treatment
by becoming willing to take responsibility for their con-
dition and health, and to change their behaviors and
lifestyles in the interest of healing.

Side effects

AM medications are safe and non-toxic. During
treatment, some patients may experience what doctors
call “healing crises.” During these, patients may tem-

Anthroposophical medicine

Antioxidants

KEY TERMS

Ayurvedic medicine — System of healing originat-
ing in ancient India.

Chi — Universal life energy as defined by tradition-
al Chinese medicine. Also known as qi.

Homeopathy — System of healing using minute, di-
luted doses of remedies that would otherwise pro-
duce symptoms of the treated disease. Prepared
from plant, animal, mineral and human sources,
they are tailored for individualized treatment.

Yin and yang — Two opposite and complimentary
characteristics used to describe the universe and
phenomena, defined by traditional Chinese medi-
cine.

porarily experience a worsening of symptoms as part of
the healing process, including fever, headaches, nausea,
weakness, muscle soreness, and other symptoms.

Research & general acceptance

Active research in AM is being regularly conducted
in Europe, mainly in Germany, Holland, Switzerland, and
France. Several research organizations performing patient-
centered research have shown promising results with the
AM cure for cancer, which utilizes the herbal remedy
mistletoe extract, and for other conditions. Other research
has shown that AM is less expensive than conventional
medical treatment, with 50% fewer illness days than when
treated by conventional practitioners. Current research
studies appear in the quarterly Journal of Anthroposophi-
cal Medicine , as well as in European publications.

Training & certification

Currently, there is no course for the certification of
AM practitioners, although every AM doctor is required
to obtain training as a certified M.D. Afterwards, physi-
cians may specialize in AM by taking a series of courses
or by interning with specialists. The Physicians Associa-
tion for Anthroposophic Medicine (PAAM) is the largest
association in North America. The organization for non-
M.D. health professionals interested in anthroposophical
medicine is Artemesia, The Association for Anthropo-
sophical Renewal of Healing.

Resources

BOOKS

Bott, Victor. Anthroposophical Medicine. Hudson, New York:

Anthroposophic Press, 1985.

100

Steiner, Rudolph. Introducing Anthroposophic Medicine. Hud-
son, New York: Anthroposophical Press, 1998.

ORGANIZATIONS

Anthroposophic Press. RR 4 Box 94 A-l. Hudson, NY 518-
851-2054.

Artemesia, The Association for Anthroposophical Renewal of
Healing. 1923 Geddes Avenue, Ann Arbor, MI 48104,
(734) 930-9462.

Gilpen Street Holistic Center. Dr. Philip Incao, M.D., 1624
Gilpen Street, Denver, CO 80218, (303) 321-2100.

Physicians Association for Anthroposophic Medicine (PAAM).
1923 Geddes Avenue. Ann Arbor, MI 48104, (734) 930-
9462.

Douglas Dupler

Antioxidants

Description

Antioxidants are a broad group of compounds that
destroy single oxygen molecules, also called free radi-
cals, in the body, thereby protecting against oxidative
damage to cells. They are essential to good health and
are found naturally in a wide variety of foods and plants,
including many fruits and vegetables. Many antioxi-
dants, either singly or in combination, are also available
as over-the-counter nutritional supplements in tablet or
capsule form. The most commonly used antioxidants are
vitamin C, vitamin E, and beta carotene. Others in-
clude grape seed extract, vitamin A, selenium, and
coenzyme Q 10 . It is unknown whether or not supplemen-
tal antioxidants provide the same benefits as those occur-
ring naturally in foods, however.

General use

In brief, antioxidants destroy free radicals in the
body. Free radicals are byproducts of oxygen metabo-
lism that can damage cells and are among the causes of
many degenerative diseases, especially diseases associat-
ed with aging. They are also associated with the aging
process itself. As a person ages, cell damage accumu-
lates, and supplementing the diet with extra antioxidant-
rich foods can help slow the oxidative damage done to
cells. Scientific studies validate the role of antioxidants
in preventing many diseases. Although studies have
shown lower rates of cancer and heart disease in people
who eat a recommended amount of fruits and vegetables,
recent clinical studies have shown that supplementation

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

of diet with antioxidant vitamin therapy does not lower
risk of cardiovascular disease or certain other diseases.

Many herbs and medicinal plants are good natural
sources of antioxidants. These include carrots, tomatoes,
yams, leafy greens, blueberries, billberries, ginkgo bilo-
ba, garlic, and green tea, to name a few. A diet rich in
vitamin C, vitamin E, and beta carotene may help reduce
the risk of some cancers, heart disease, cataracts, and
strokes.

Vitamin A

A study by the University of Arizona found that vita-
min A has a protective affect against many types of cancer,
according to Dr. Michael Colgan in his book, The New
Nutrition. Vitamin A is a fat-soluble antioxidant found in
animal products but can be made by the body from its pre-
cursor, beta carotene. Foods rich in vitamin A are liver,
eggs, and fortified dairy products. Vitamin A helps bones
and teeth develop, and promotes vision. As an antioxidant,
it protects cell membranes and fatty tissue, helps repair
damage caused by air pollutants, and boosts the immune
system. A deficiency of this vitamin can result in dry skin,
brittle hair, vision problems, blindness, and increased sus-
ceptibility to respiratory infections.

Vitamin C

Probably the most widely used of all vitamin supple-
ments, vitamin C is a powerful antioxidant that has a myr-
iad of functions and helps strengthen the immune system.
It became famous in the 1970s when Nobel Prize-winning
scientist Linus Pauling advocated daily mega doses (8-10
grams) of vitamin C to prevent and ease the symptoms of
the common cold. Many clinical studies that show vita-
min C is superior to over-the-counter medicines in reduc-
ing the symptoms, duration, and severity of colds. As an
antioxidant, vitamin C may help fight cardiovascular dis-
ease by protecting the linings of arteries from oxidative
damage. In 2002, debate still continued on the vitamin’s
effects on heart disease. One study revealed that Vitamins
C and E helped reduce arteriosclerosis (hardening of the
arteries) following heart transplants. Yet another study
demonstrated that vitamin therapy had not effect on pre-
venting heart disease. There is some evidence and re-
search that vitamin C can help prevent cancer. Studies
have shown it is also beneficial in protecting the body
against the effects of smoking and air pollutants.

Vitamin E

Vitamin E is a potent antioxidant by itself, but its ef-
fectiveness is magnified when taken with other antioxi-
dants, especially vitamin C, selenium, and beta carotene.
Some scientific evidence indicates that vitamin E helps

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

promote cardiovascular health. Past studies have demon-
strated higher vitamin E intake is associated with de-
creased incidence of heart disease in both men and women.
In fact, the combination of Vitamin C and E can slow pro-
gression of cardiovascular disease following heart trans-
plant. In 2002, researchers stated that the vitamin combina-
tion might also be useful in other organ transplants. In ad-
dition, Harvard Medical School reported in the same year
that Vitamin E might play a role in helping people live
longer, citing its role in strengthening the immune system.

Carotenoids

This class of antioxidants includes beta carotene,
lutein, and lycopene. They are found in a variety of
fruits and vegetables such as carrots, pumpkins, kale,
spinach, tomatoes, and pink grapefruit. Research evi-
dence suggests carotenoids lower the risk of heart dis-
ease and some types of cancer, and strengthen the im-
mune system. Lycopene, which is concentrated in the
prostate gland, is believed to protect the prostate from
cancer. Lutein is thought to prevent macular degenera-
tion, a major cause of blindness, or stop its progression.
Beta carotene increases the lungs’ defense system in
smokers or those exposed to other air-borne pollutants. It
also has been used as an immune system stimulator in
people with AIDS. In 2002, a report revealed that more
than 90% of ophthalmologists and optometrists surveyed
believe that lutein helps prevent eye disease.

Bioflavonoids

Bioflavonoids are a group of about 5,000 com-
pounds that act as antioxidants. They occur in fruits, veg-
etables, green tea, soy products, herbs, and spices. A
combination of bioflavonoids has a synergistic effect
when taken with vitamin C. They have been shown to be
beneficial in treating a variety of conditions, including
allergies, arthritis, diabetes, hypertension, and viral in-
fections. One group of bioflavonoids found to be a pow-
erful antioxidant is oligomeric proanthocyanidins
(OPCs), also known generically as pycnogenol. Ex-
tremely high concentrations of OPCs are found in mar-
itime pine bark ( Finns maritima) extract, grape seed ex-
tract, and grape and peanut skins. Due primarily to its
much lower cost, grape seed extract is the most com-
monly used OPC. Procyanidins, a group of compounds
found in the extract, are thought to increase the effective-
ness of other antioxidants, especially vitamin C and vita-
min E, by helping them regenerate after neutralizing free
radicals in the blood and tissue.

Other antioxidants

The other widely used antioxidants are selenium, coen-
zyme Q 10 , and certain amino acids. Selenium, especially

101

Antioxidants

when teamed with vitamin E, may help protect against
lung, colon, prostate, and rectum cancers. The antioxidant
benefits of coenzyme Q 10 may include slowing the aging
process, boosting the immune system, and preventing ox-
idative damage to the brain. Some still suggest its use to
treat a variety of cardiovascular diseases. Amino acids that
have strong antioxidant effects include alpha lipoic acid,
cysteine, glutathione, and N-acetyl cysteine (NAC).

Preparations

Bottled antioxidant formulae are available in a single
pill or as part of a multivitamin. The usual dosages of an-
tioxidants taken individually can vary widely. The United
States Department of Agriculture (USDA) has established
recommended daily allowance, but these may be conserv-
ative amounts for preventing diseases. For instance, the
USDA recommendation for vitamin C is 60 mg a day but
natural healthcare practitioners commonly recommend
500 mg a day or more. The dosage may also depend on
whether it is being taken to treat or prevent a specific con-
dition. With that in mind, the common daily dosages for
specific antioxidants are: vitamin A, 5,000-15,000 IU;
beta carotene, 15,000-25,000 IU; vitamin C, 250-1,500
mg; vitamin E, 30-400 IU; selenium, 50-400 micrograms;
bioflavonoids, 100-500 mg; grape seed extract, 150-200
mg; coenzyme Q 10 , 90-150 mg; alpha lipoic acid, 20-50
mg or 300-600 mg for elevated blood sugar levels; glu-
tathione, 100 mg; N-acetyl cysteine, 600 mg.

Precautions

Vitamin C: May interfere with some laboratory tests,
including urinary sugar spilling for diabetics. Vitamin A:
Can be toxic in high doses of more than 15,000 IU per day
or chronic doses for months, and may cause birth defects if
taken in high doses during pregnancy. In 2002, one study
showed that consistent Vitamin A intake could increase the
risk of hip fractures in postmenopausal women, but the
study was not representative of all women, and more study
on the upper limits of safe Vitamin A consumption for
women in their 40s and 50s is needed. Vitamin E: Danger-
ous in very high doses. Carotenoids: No known precau-
tions are indicated for normal doses. Bioflavonoids: No
known precautions are indicated for normal doses. Seleni-
um: No precautions indicated at normal doses, but a physi-
cian should be consulted before taking daily doses of more
than 200 micrograms. Coenzyme Q 10 : No known precau-
tions are indicated for normal dosage. Amino acids: There
are no known precautions indicated for alpha lipoic acid,
cysteine, glutathione, or NAC.

Side effects

Vitamin C: Individual tolerances vary. High doses
may cause cramps, diarrhea, ulcer flare-ups, kidney

102

stones, and gout in some people. Vitamin A: High doses
can lead to headaches, nausea, hair loss, and skin le-
sions; may cause bone disease in people with chronic
kidney failure. Vitamin E: Usually no adverse side ef-
fects in doses of up to 400 mg a day, high doses may ele-
vate blood pressure and lead to blood-clotting problems.
Carotenoids: No known side effects occur with normal
dosage. Bioflavonoids: No known negative side effects
in normal doses. Selenium: No reported adverse side ef-
fects with normal dosage of 200 micrograms, higher
doses may cause dizziness and nausea. Coenzyme Q 10 :
No adverse side effects have been reported. Amino acids:
There are no known side effects associated with normal
doses of alpha lipoic acid, cysteine, glutathione, or NAC.

Interactions

Vitamin C: No known common adverse interactions
with other drugs. Vitamin A: Women taking birth control
pills should consult with their doctors before taking extra
vitamin A. Vitamin E: Should not be used by persons
taking anti-coagulation drugs. Carotenoids: No known
negative interactions with other drugs. Bioflavonoids:
No known adverse interactions with other drugs. Coen-
zyme Q 10 : No negative drug interactions yet reported.
Amino acids: There are no adverse reactions yet reported
between alpha lipoic acid, cysteine, glutathione, or NAC
and other medications.

Resources

BOOKS

Balch, Dr. James F. The Super Antioxidants: Why They Will
Change the Face of Health Care in the 21st Century. M.
Evans and Co., 1998.

Colgan, Dr. Michael. The New Nutrition. Cl Publications,
1996.

Challem, Jack, editor. All About Antioxidants. Avery Publishing
Group, 1999.

Hendler, Dr. Sheldon Saul The Doctors' Vitamin and Mineral
Encyclopedia. Simon and Shuster, 1990.

Moss, Ralph W. Antioxidants Against Cancer. Equinox Press,
2000 .

Murray, Michael T. Natural Alternatives to Over-the-Counter
and Prescription Drugs. William Morrow and Co., 1994.
Packer, Lester, et al. The Antioxidant Miracle: Your Complete
Plan For Total Health and Healing. John Wiley and Sons,
1999.

Smythies, John R. Every Person's Guide to Antioxidants Rut-
gers University Press, 1998.

PERIODICALS

Abramowiez, Dr. Mark, editor. “Vitamin Supplements.” The
Medical Letter ( July 31, 1998): 75- 77.

“Antioxidant Vitamin E Reported to Strengthen Immune Sys-
tem.” Obesity, Fitness & Wellness Week (March 2, 2002):
12 .

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Atherosclerosis — A buildup of fatty substances in
the inside of arteries, resulting in the restriction of
blood flow and hardening of the vessels.

Macular degeneration — An eye disease resulting
in a loss of central vision in both eyes while pe-
ripheral vision is preserved.

Oxidation — The loss of electrons from a molecule
by their bonding to an oxygen molecule, render-
ing the donor molecule positive in charge and the
recipient oxygen negative in charge (free radical).
Sinusitis — An inflammation or infection in the
sinus cavities in the head.

Fang, James C., et al. “Effect of Vitamins C and E on Progres-
sion of Transplant- Associated Arteriosclerosis: A random-
ized Trial.” The Lancet (March 30, 2002): 1108.

Kiningham, Robert.“The Value of Antioxidant Vitamin Supple-
ments.” American Family Physician (Sept. 1, 1999): 742.

Koch Kubetin, Sally. “Antioxidants Fall Short.” OB GYN News
(February 1, 2002): 29.

Langer, Stephen. “Antioxidants: Our Knights in Shining
Armor.” Better Nutrition (May 1997): 46- 50.

"Lutein Helps Protect Eyes, Doctors Say in Survey.” Ophthal-
mology Times (March 15, 2002): 29.

Raloff, Janet. “The Heart-Healthy Side of Lycopene.” Science
News (Nov. 29, 1997): 348.

Scheer, James F. "Twelve Key Antioxidants: May Their Force
Be With You.” Better Nutrition (Jan. 1999): 58.

Schindler, Martha.“The Magnificent Seven.” Vegetarian Times
(Feb. 1999): 86.

“Simvastatin Yes, Antioxidant No n Two Important New Stud-
ies.” Clinical Cardiology Alert (January 2002): 1.

Tyler, Varro E.“The Miracle of Anti- Aging Herbs.” Prevention
(Nov. 1999): 105.

“Vitamin A Intake Levels Reaffirmed as Safe and Beneficial.”
Medical Letter on the CDC & FDA (January 27, 2002): 14.

Ken R. Wells
Teresa G. Odle

Anxiety

Definition

Anxiety is a bodily response to a perceived threat or
danger. It is triggered by a combination of biochemical
changes in the body, the patient's personal history and
memory, and the social situation.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

It is important to distinguish between anxiety as a
feeling or experience and an anxiety disorder as a psy-
chiatric diagnosis. A person may feel anxious without
having an anxiety disorder. Also, a person facing a clear
and present danger or a realistic fear is not usually con-
sidered to be in a state of anxiety. In addition, anxiety
frequently occurs as a symptom in other categories of
psychiatric disturbance.

Description

Anxiety is related to fear, but it is not the same
thing. Fear is a direct, focused response to a specific
event or object of which an individual is consciously
aware. Most people will feel fear if someone points a
loaded gun at them or if they see a tornado forming on
the horizon. They also will recognize that they are afraid.
Anxiety, on the other hand, is often unfocused, vague,
and hard to pin down to a specific cause.

Sometimes anxiety experienced in the present may
stem from an event or person that produced pain and
fear in the past. In this experience, the anxious individual
may not be consciously aware of the original source of
the feeling. Anxiety has an aspect of remoteness that
makes it hard for people to compare their experiences.
Whereas most people will be fearful in physically dan-
gerous situations, and can agree that fear is an appropri-
ate response in the presence of danger, anxiety is often
triggered by objects or events that are unique and specif-
ic to an individual. An individual might be anxious be-
cause of a unique meaning or memory being stimulated
by present circumstances, not because of some immedi-
ate danger.

Causes & symptoms

Anxiety is characterized by the following symp-
toms:

• Somatic. These physical symptoms include headaches,
dizziness or lightheadedness, nausea and/or vomiting,
diarrhea, tingling, pale complexion, sweating, numb-
ness, difficulty in breathing, and sensations of tightness
in the chest, neck, shoulders, or hands. These symptoms
are produced by the hormonal, muscular, and cardiovas-
cular reactions involved in the fight-or-flight reaction.

• Behavioral. Behavioral symptoms of anxiety include
pacing, trembling, general restlessness, hyperventilation,
pressured speech, hand wringing, and finger tapping.

• Cognitive. Cognitive symptoms of anxiety include re-
current or obsessive thoughts, feelings of doom, mor-
bid or fear-inducing thoughts or ideas, and confusion or
inability to concentrate.

103

Anxiety

• Emotional. Emotional symptoms include feelings of
tension or nervousness, feeling “hyper” or “keyed up,”
and feelings of unreality, panic, or terror.

Anxiety can have a number of different causes. It is
a multidimensional response to stimuli in the person’s
environment, or a response to an internal stimulus (for
example, a hypochondriac’s reaction to a stomach rum-
bling) resulting from a combination of general biological
and individual psychological processes.

Physical triggers

In some cases, anxiety is produced by physical re-
sponses to stress or by certain disease processes or med-
ications.

THE AUTONOMIC NERVOUS SYSTEM (ANS). The ner-
vous system of human beings is hard-wired to respond to
dangers or threats. These responses are not subject to
conscious control and are the same in humans as in
lower animals. They represent an evolutionary adapta-
tion to animal predators and other dangers that all ani-
mals — including primitive humans — had to cope with.

The most familiar reaction of this type is the fight-
or-flight reaction to a life-threatening situation. When
people have fight-or-flight reactions, the level of stress
hormones in their blood rises. They become more alert
and attentive, their eyes dilate, their heartbeats increase,
their breathing rates increase, and their digestion slows
down, making more energy available to the muscles.

This emergency reaction is regulated by a part of the
nervous system called the autonomic nervous system, or
ANS. The ANS is controlled by the hypothalamus, a spe-
cialized part of the brainstem that is among a group of
structures called the limbic system. The limbic system
controls human emotions through its connections to
glands and muscles; it also connects to the ANS and
higher brain centers, such as parts of the cerebral cortex.

One problem with this arrangement is that the lim-
bic system cannot tell the difference between a real
physical threat and an anxiety-producing thought or idea.
The hypothalamus may trigger the release of stress hor-
mones from the pituitary gland even when there is no ex-
ternal danger.

A second problem is caused by the biochemical side
effects of too many false alarms in the ANS. When a per-
son responds to a real danger, his or her body relieves it-
self of the stress hormones by facing up to the danger or
fleeing from it. In modern life, however, people often
have fight-or-flight reactions in situations where they can
neither run away nor lash out physically. As a result, their
bodies have to absorb all the biochemical changes of hy-
perarousal rather than release them. These biochemical

104

changes can produce anxious feelings as well as muscle
tension and other physical symptoms of anxiety.

DISEASES AND DISORDERS. Anxiety can be a symp-
tom of certain medical conditions. For example, anxiety
is a symptom of certain endocrine disorders that are
characterized by overactivity or underactivity of the thy-
roid gland. Cushing’s syndrome, in which the adrenal
cortex overproduces cortisol, is one such disorder. Other
medical conditions that can produce anxiety include res-
piratory distress syndrome, mitral valve prolapse, por-
phyria, and chest pain caused by inadequate blood sup-
ply to the heart (angina pectoris).

MEDICATIONS AND SUBSTANCE USE. Numerous
medications may cause anxiety-like symptoms as a side
effect. They include birth control pills, some thyroid or
asthma drugs, some psychotropic agents, corticos-
teroids, antihypertensive drugs, nonsteroidal anti-inflam-
matory drugs (such as flurbiprofen and ibuprofen), and
local anesthetics. Caffeine can also cause anxiety-like
symptoms when consumed in sufficient quantity.

Withdrawal from certain prescription drugs — pri-
marily beta-blockers and corticosteroids — can cause anx-
iety. Withdrawal from drugs of abuse, including LSD, co-
caine, alcohol, and opiates, can also cause anxiety.

Childhood development and anxiety

Researchers in early childhood development regard
anxiety in adult life as a residue of childhood memories
of dependency. Humans learn during the first year of life
that they are not self-sufficient and that their basic sur-
vival depends on others. It is thought that this early expe-
rience of helplessness underlies the most common anxi-
eties of adult life, including fear of powerlessness and
fear of not being loved. Thus, adults can be made anx-
ious by symbolic threats to their sense of competence or
significant relationships, even though they are no longer
helpless children.

Symbolization

The psychoanalytic model gives a lot of weight to
the symbolic aspect of human anxiety; examples include
phobic disorders, obsessions, compulsions, and other
forms of anxiety that are highly individualized. Because
humans mature slowly, children and adolescents have
many opportunities to connect their negative experiences
to specific objects or events that can trigger anxious feel-
ings in later life. For example, a person who was fright-
ened as a child by a tall man wearing glasses may feel
panicky years later, without consciously knowing why, by
something that reminds him of that person or experience.

Freud thought that anxiety results from a person’s in-
ternal conflicts. According to his theory, people feel anx-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ious when they feel tom between moral restrictions and
desires or urges toward certain actions. In some cases, the
person’s anxiety may attach itself to an object that repre-
sents the inner conflict. For example, someone who feels
anxious around money may be pulled between a desire to
steal and the belief that stealing is wrong. Money be-
comes a symbol for the inner conflict between doing
what is considered right and doing what one wants.

Phobias

Phobias are a special type of anxiety reaction in
which the person concentrates his or her anxiety on a
specific object or situation and then tries to avoid. In
most cases, the person’s fear is out of proportion to its
“cause.” It is estimated that 10-11% of the population
will develop a phobia in their lifetime. Some phobias —
agoraphobia (fear of open spaces), claustrophobia (fear
of small or confined spaces), and social phobia, for ex-
ample — are shared by large numbers of people. Others
are less common or are unique to the patient.

Social and environmental stressors

Because humans are social creatures, anxiety often
has a social dimension. People frequently report feelings
of high anxiety when they anticipate or fear the loss of
social approval or love. Social phobia is a specific anxi-
ety disorder that is marked by high levels of anxiety or
fear of embarrassment in social situations.

Another social stressor is prejudice. People who be-
long to groups that are targets of bias have a higher risk
of developing anxiety disorders. Some experts think, for
example, that the higher rates of phobias and panic dis-
order among women reflects their greater social and
economic vulnerability.

Several controversial studies indicate that the in-
crease in violent or upsetting pictures and stories in news
reports and entertainment may raise people’s anxiety lev-
els. Stress and anxiety management programs often rec-
ommend that patients cut down their exposure to upset-
ting stimuli.

Environmental or occupational factors can also
cause anxiety. People who must live or work around sud-
den or loud noises, bright or flashing lights, chemical va-
pors, or similar nuisances that they cannot avoid or con-
trol may develop heightened anxiety levels.

Diagnosis

Diagnosing anxiety is difficult and complex because
of the variety of possible causes and because each per-
son’s symptoms arise from highly personalized and indi-
vidualized experiences. When a doctor examines an anx-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ious patient, he or she will first rule out physical condi-
tions and diseases that have anxiety as a symptom. The
doctor will then take the patient’s history to see if pre-
scription drugs, alcohol or drug abuse, caffeine, work en-
vironment, or other external stressors could be triggering
the anxiety. In most cases, the most important source of
diagnostic information is the patient’s psychological and
social history. The doctor may administer several brief
psychological tests, including the Hamilton Anxiety Scale
and the Anxiety Disorders Interview Schedule (ADIS).

Treatment

Meditation and mindfulness training can benefit
patients with phobias and panic disorder. Hydrother-
apy, massage therapy, and aromatherapy are useful to
some anxious patients because they can promote general
relaxation of the nervous system. Essential oils of
lavender, chamomile, neroli, sweet marjoram, and
ylang-ylang are commonly recommended by aromather-
apists for stress relief and anxiety reduction.

Relaxation training, which is sometimes called anxi-
ety management training, includes breathing exercises
and similar techniques intended to help the patient pre-
vent hyperventilation and relieve the muscle tension as-
sociated with the fight-or-flight reaction. Yoga, aikido,
tai chi, and dance therapy help patients work with the
physical, as well as the emotional, tensions that either
promote anxiety or are created by the anxiety.

Homeopathy and traditional Chinese medicine

(TCM) approach anxiety as a symptom of a holistic im-
balance. Homeopathic practitioners select a remedy based
on other associated symptoms and the patient’s general
constitution. Homeopathic remedies for anxiety include
ignatia, gelsemium, aconite, pulsatilla, arsenicum
album, and coffea cruda. These remedies should be pre-
scribed by a homeopathic healthcare professional.

Chinese medicine regards anxiety as a disruption of qi ,
or energy flow, inside the patient’s body. Acupuncture
and/or herbal therapy are standard remedies for rebalancing
the entire system. Reishi ( Ganoderma lucidum or Ling-Zhi)
is a medicinal mushroom prescribed in TCM to reduce anx-
iety and insomnia. However, because reishi can interact
with other prescription drugs and is not recommended for
patients with certain medical conditions, individuals should
consult their healthcare practitioner before taking the reme-
dy. Other TCM herbal remedies for anxiety include the
cordyceps mushroom (also known as catepillar fungus)
and Chinese green tea. In addition, there are numerous
TCM formulas that combine multiple herbs for use as an
anxiety treatment, depending on the individual problem.

Herbs known as adaptogens may also be prescribed
by herbalists or holistic healthcare providers to treat anxi-

105

Anxiety

ety. These herbs are thought to promote adaptability to
stress, and include Siberian ginseng ( Eleutherococcus sen-
ticosus), ginseng ( Panax ginseng ), wild yam (Dioscorea
villosa), borage ( Borago officinalis), licorice ( Glycyrrhiza
glabra), chamomile ( Chamaemelum nobile), milk thistle
(Silybum marianum), and nettles ( Urtica dioica). Tonics
of skullcap ( Scutellaria lateriafolia), and oats (Arena
sativa), may also be recommended to ease anxiety.

A 2002 preliminary study found that St. John’s wort
could be an effective treatment for generalized anxiety.
Patients taking 900 mg a day and higher doses responded
well in early trials. However, further research was need-
ed, particularly at doses higher than 900 mg per day. The
Ayurvedic herb gotu kola, long used by practitioners of
India’s holistic medical system to enhance memory and
relieve varicose veins, may also help patients with anxi-
ety by working against the startle response.

Allopathic treatment

Because anxiety often has more than one cause and
is experienced in highly individual ways, its treatment
often requires more than one type of therapy. In some
cases, several types of treatment may need to be tried be-
fore the best combination is discovered. It usually takes
about six to eight weeks to evaluate the effectiveness of a
treatment regimen.

Medications

Medications are often prescribed to relieve the phys-
ical and psychological symptoms of anxiety. Most med-
ications work by counteracting the biochemical and
muscular changes involved in the fight-or-flight reaction.
Some work directly on the brain chemicals that are
thought to underlie the anxiety.

ANXIOLYTICS. Anxiolytics are sometimes called
tranquilizers. Most anxiolytic drugs are either benzodi-
azepines or barbiturates. However, barbiturates, once
commonly used, are now rarely used in clinical practice.
Benzodiazepines work by relaxing the skeletal muscles
and calming the limbic system. They include such drugs
as chlordiazepoxide (Librium) and diazepam (Valium).
Both barbiturates and benzodiazepines are potentially
habit-forming and may cause withdrawal symptoms, but
benzodiazepines are far less likely than barbiturates to
cause physical dependency.

Two other types of anxiolytic medications include
meprobamate (Equanil), which is now rarely used, and
buspirone (BuSpar), a new type of anxiolytic that ap-
pears to work by increasing the efficiency of the body’s
own emotion-regulating brain chemicals. Unlike barbitu-
rates and benzodiazepines, buspirone does not cause de-

106

pendence problems, does not interact with alcohol, and
does not affect the patient’s ability to drive or operate
machinery. However, buspirone is not effective against
certain types of anxiety, such as panic disorder.

ANTIDEPRESSANTS AND BETA-BLOCKERS. The treat-
ment of choice for obsessive-compulsive disorder,
panic type anxiety, and other anxiety disorders is a group
of antidepressants known as selective serotonin reuptake
inhibitors (SSRIs), such as Prozac and Paxil. When anxi-
ety occurs in tandem with depressive symptoms, tricyclic
antidepressants such as imipramine (Tofranil) or
monoamine oxidase inhibitors (MAO inhibitors) such as
phenelzine (Nardil) are sometimes prescribed.

Beta-blockers are medications that work by block-
ing the body's reaction to the stress hormones that are re-
leased during the fight-or-flight reaction. They include
drugs like propranolol (Inderal) or atenolol (Tenormin).
Beta-blockers are sometimes given to patients with post-
traumatic anxiety symptoms or social phobic anxiety.

Psychotherapy

Most patients with anxiety will be given some form
of psychotherapy along with medication. Many patients
benefit from insight-oriented therapies, which are de-
signed to help them uncover unconscious conflicts and
defense mechanisms in order to understand how their
symptoms developed.

Cognitive-behavioral therapy (CBT) also works well
with anxious patients. In CBT, the patient is taught to
identify thoughts and situations that stimulate his or her
anxiety, and to view them more realistically. In the be-
havioral part of the program, the patient is exposed to the
anxiety-provoking object, situation, or internal stimulus
(like a rapid heart beat) in gradual stages until he or she
is desensitized to it.

Expected results

Unfortunately, a 2002 report stated that about half of
the patients with an anxiety disorder who see their pri-
mary care physician go untreated. The prognosis for re-
solving anxiety depends on the specific disorder and a
wide variety of factors, including the patient’s age, gen-
eral health, living situation, belief system, social support
network, and responses to different medications and
forms of therapy.

Resources

BOOKS

“Anxiety Disorders.” In Diagnostic and Statistical Manual of

Mental Disorders. 4th ed. Washington, DC: The American

Psychiatric Association, 1994.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Anxiolytic — A type of medication that helps to re-
lieve anxiety.

Aromatherapy — The therapeutic use of plant-de-
rived, aromatic essential oils to promote physical
and psychological well-being.

Autonomic nervous system (ANS) — The part of
the nervous system that supplies nerve endings in
the blood vessels, heart, intestines, glands, and
smooth muscles; it also governs their involuntary
functioning. The autonomic nervous system is re-
sponsible for the biochemical changes involved in
experiences of anxiety.

Endocrine gland — A ductless gland, such as the
pituitary, thyroid, or adrenal gland, that secretes
its products directly into the blood or lymph.
Hyperarousal — A state or condition of muscular
and emotional tension produced by hormones re-
leased during the fight-or-flight reaction.

Hypothalamus — A portion of the brain that regu-
lates the autonomic nervous system, the release of
hormones from the pituitary gland, sleep cycles,
and body temperature.

Limbic system — A group of structures in the brain
that includes the hypothalamus, amygdala, and
hippocampus. The limbic system plays an impor-
tant part in regulation of human moods and emo-
tions.

Phobia — In psychoanalytic theory, a psychologi-
cal defense against anxiety in which the patient
displaces anxious feelings onto an external object,
activity, or situation.

Bloomfield, Harold H. Healing Anxiety with Herbs. New York:
HarperCollins, 1998.

Corbman, Gene R. "Anxiety Disorders." In Current Diagnosis
9, edited by Rex B. Conn, et al. Philadelphia: W. B. Saun-
ders, 1997.

PERIODICALS

Gaby, Alan R. “Consider St. John's Wort as Alternative to
Kava. (Literature Review & Commentary).” Townsend
Letter for Doctors and Patients (May 2002):34.

Mandile, Maria Noel. “Gotu Kola: This Ayurvedic Herb May
Reduce Your Anxiety Without the Side Effects of Drugs.”
Natural Health (May-June 2002):34.

Zoler. Michael L. “Anxiety Disorder Often Goes Untreated in
Primary Care. (504 Patients in 15 Practices Studied).”
Family Practice News (April 1, 2002): 14 -21.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ORGANIZATION

The American Botanical Council. P.O. Box 144345, Austin,
Texas 78714-4345. (512) 926-4900. Fax: (512) 926-2345.
http://www.herbalgram.org.

Paula Ford-Martin
Teresa G. Odle

Apis

Description

Not all products used in alternative healing come
from plants. Apis mellifica is the venom of the common
honeybee or a tincture made from the whole bee. Various
species of honeybees found throughout the world are
used for this remedy in homeopathic medicine. The rem-
edy made from them is usually called apis. Other folk
medicine traditions use additional bee-related substances
in healing such as honey, beeswax, pollen, royal jelly,
and propolis.

General use

Homeopathic medicine operates on the principle
that “like heals like.” This means that a disease can be
cured by treating it with products that produce the same
symptoms as the disease. These products follow another
homeopathic law, the Law of Infinitesimals. In opposi-
tion to traditional medicine, the Law of Infinitesimals
states that the lower a dose of curative, the more effec-
tive it is. To make a homeopathic remedy, the curative is
diluted many, many times until only a tiny amount re-
mains in a huge amount of the diluting liquid.

In homeopathic terminology, the effectiveness of
remedies is “proved” by experimentation and reports by
famous homeopathic practitioners. About 1900, both bee
venom and tincture from the entire insect were proved as
a remedy by the Central New York State Homeopathic
Society.

In homeopathic medicine, apis is used as a remedy
for many symptoms similar to those of bee stings. These
include:

• inflammation with a burning sensation

• stinging pain

• itchy skin

• swollen and sensitive skin

• red, flushed, hot face

• hive-like welts on the skin

107

Homeopathic practitioners use apis when stinging or
burning inflammations appear in all parts of the body,
not just on the skin. A homeopath could use apis for sore
throats, mumps, urinary tract infections, and other con-
ditions where there is a stinging or burning sensation.

Symptoms treated by apis usually appear quite rapid-
ly. There is usually some swelling or edema along with
the stinging sensation. Many people who need apis com-
plain of swollen eyelids, as if they had an eye infection. In
keeping with the symptom of edema, often little urine is
produced although there may be a strong urge to urinate.
Despite this, the patient has little thirst or desire to drink.

Often the patient who will be given apis appears
flushed or has a rough rash. The rash may appear, then
disappear. The skin will be sensitive to the touch and al-
ternatively hot and dry, then sweaty. Patients may also
feel nauseated, suffer from heartburn, or have tightness
throughout their chest or abdomen that feels like they
will burst if they cough or strain.

Certain mental and emotional symptoms also appear
in the patient that needs apis. Sadness, weeping, and de-
pression can occur. Apis is often used after a person ex-
periences a strong emotional reaction such as jealousy,
fear, rage, or anger.

In homeopathic medicine, the fact that certain
symptoms get better or worse under different conditions
is used as a diagnostic tool to indicate what remedy will
be most effective. Symptoms that benefit from treatment
with apis get worse by applying warmth or drinking
warm liquids. They also get worse from touch or pres-
sure, or when the person is in a closed, heated room. The
symptoms are often worse on the right side, after sleep-
ing, and in the late afternoon. Symptoms improve with
the application of cold and exposure to open air.

Homeopathy also ascribes certain personality types
to certain remedies. The apis personality is said to be fid-
gety, restless, and unpredictable. People with the apis per-
sonality may have wildly inappropriate reactions to emo-
tional situations. They want company, but reject affection,
and sometimes insist that they don’t need medical atten-
tion when they are clearly unwell. People who need apis
often have bouts of unprovoked jealousy and unprovoked
tears. They may fear ill health and death greatly.

Preparations

There are two homeopathic dilution scales, the deci-
mal (x) scale with a dilution of 1:10 and the centesimal
(c) scale with a dilution factor of 1:100. Once the mix-
ture is diluted, shaken, strained, then rediluted many
times to reach the desired degree of potency, the final
mixture is added to lactose (a type of sugar) tablets or

108

KEY TERMS

Edema — Puffiness caused by water retention.

Propolis — A sticky resin made by honeybees to
seal the holes in their hives.

Royal jelly — Special substance secreted by bees to
feed the young queen bees.

Tincture — An extract prepared by soaking the
remedy in alcohol.

pellets. These are then stored away from light. Homeo-
pathic apis venom is available commercially in tablets in
many different strengths. Dosage depends on the symp-
toms being treated. Homeopathic tincture of whole hon-
eybee is also available in a variety of strengths.

Homeopathic and orthodox medical practitioners
agree that by the time the initial remedy solution is dilut-
ed to strengths used in homeopathic healing, it is likely
that very few molecules of the original remedy remain.
Homeopaths, however, believe that these remedies con-
tinue to work through an effect called “potentization”
that has not yet been explained by mainstream scientists.

Precautions

No particular precautions have been noted for using
apis. However, people who are allergic or sensitive to
bee venom should be cautious. They may react adversely
to certain potencies of homeopathic apis.

Side effects

When taken in the recommended dilute form, no
side effects from apis have been reported. However, con-
centrated quantities of the bee venom can cause allergic
reactions in susceptible people.

Interactions

Studies on interactions between apis and conven-
tional pharmaceuticals are nonexistent.

Resources

BOOKS

Cummings, Stephen, and Dana Ullman. Everybody' s Guide to
Homeopathic Medicines. 3rd ed. New York: Putnam,
1997.

Hammond, Christopher. The Complete Family Guide to Home-
opathy. London: Penguin Studio, 1995.

Lockie, Andrew, and Nicola Geddes. The Complete Guide to
Homeopathy. London: Dorling Kindersley, 1995.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ORGANIZATIONS

Foundation for Homeopathic Education and Research. 21 Kit-
tredge St., Berkeley, CA 94704. (510) 649-8930.

International Foundation for Homeopathy. RO. Box 7, Ed-
monds, WA 98020. (206) 776-4147.

National Center for Homeopathy. 801 N. Fairfax St., Suite 306,
Alexandria, VA 22314. (703) 548-7790.

OTHER

Homeopathic Internet Resources, <http://www.holisticmed.com/>
and <www/homeopathy.html>

Tish Davidson

Apitherapy

Definition

Apitherapy involves the therapeutic use of honeybee
products, including bee pollen, honey, propolis, royal
jelly, beeswax, and venom, to treat a variety of ailments.
The most well-known and well-practiced facet of apithera-
py is Bee Venom Therapy (BVT), which involves the med-
icinal use of bee stings. The venom is thought to reduce in-
flammation and boost the body’s immune system. When
most people refer to apitherapy, they are referring to BVT.

Origins

The medicinal use of bees goes back to ancient times.
Chinese texts dating back 2,000 years mention it, and Hip-
pocrates wrote about it. The Egyptians were said to treat
diseases with an ointment made from bees, and Greek
physician and writer Galen (129-c. 199), wrote about bee
treatments. In 1888, Phillip Terc, an Austrian physician,
published a paper on one of the first clinical studies in-
volving bee stings titled Report About a Peculiar Connec-
tion Between the Beestings and Rheumatism. Thereafter,
its use expanded throughout Europe and the United States.
It spread as a type of folk remedy popularized by anecdo-
tal accounts, but as the twenty-first century approached,
the medical community began investigating the therapy,
studying its use on a pharmacological level. Though clini-
cal studies had begun by 2000, most people using the ther-
apy were either doing it themselves or with the help of lay
practitioners. Physicians were beginning to use the thera-
py but mostly with an injectable form of the venom.

Benefits

The American Apitherapy Society says it has anec-
dotal evidence showing bee venom is effective in the
treatment of:

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• immune system problems, such as arthritis and multi-
ple sclerosis (MS)

• cardiovascular disease, such as hypertension, arrhyth-
mias, atherosclerosis, and varicose veins

• endocrine disorders, such as premenstrual syndrome,
menstrual cramps, irregular periods, and decreased
blood glucose levels

• infections, like herpes simplex 1 and 2, warts, mastitis,
and laryngitis

• psychological disturbances, such as depression or
mood swings

• rheumatologic disturbances, such as rheumatoid
arthritis, osteoarthritis, juvenile rheumatoid arthri-
tis, bursitis, and “tennis elbow”

• skin conditions, such as eczema, psoriasis, corns,
warts, and topical ulcers

Apitherapy is thought of as a last-resort treatment but
may be beneficial to those who cannot be helped by tradi-
tional therapies and medicines. MS patients have reported
increased stability, along with less fatigue and muscle
spasm, after trying the therapy. Patients with rheumatoid
arthritis and osteoarthritis have said pain and swelling have
decreased following the stings. It has also been said to shrink
the size of rheumatoid nodules. For those who have not
achieved relief with other treatments, apitherapy may help.

Description

Honey bee venom contains more than 40 active sub-
stances, many of which have physiological effects. The
most abundant compound is an anti-inflammatory agent
called melittin. This substance causes the body to pro-
duce cortisol, which is an agent of the body’s own heal-
ing process. As an anti-inflammatory, melittin is 100
times more potent than hydrocortisol. It is noted in Paul
L. Cerrato’s RN article that experiments have shown that
melittin can slow the body’s inflammatory response.
That is why the venom may be helpful in treating inflam-
matory conditions such as rheumatoid arthritis.

Other compounds that may have pharmacological ef-
fects include apamin, which works to enhance nerve trans-
mission; adolapin, which is an anti-inflammatory and an
analgesic; and other neurotransmitters like norepinephrine
and dopamine and seratonin, which figure in depression.

The most prevalent use of BVT is for immune sys-
tem and inflammatory disorders. One of the most promis-
ing uses may be relieving the symptoms of treatment-re-
sistant MS. More than 1,300 people with MS have sent
testimonials to the American Apitherapy Society in sup-
port of the treatment saying the therapy helped relieve fa-
tigue and muscle spasm, as well as to restore stability.

109

Apitherapy

Most people receiving the therapy do it themselves
or with the help of a lay practitioner. The cost of learning
the therapy and the cost for the bees is generally not cov-
ered by insurance. The therapy may be covered, howev-
er, if prescribed and administered by a physician who
uses an injectable form.

To receive treatment, a bee is taken from a jar or hive
with a pair of tweezers and held on the body part to be
stung. The stinger should be left in for 10 to 15 minutes.
The number of stings delivered in a session and the fre-
quency of the sessions varies, depending on the patient’s
tolerance and the nature of the problem. To treat ten-
donitis, a patient might need only two to five therapy ses-
sions involving only two to three stings per session. Treat-
ing a more chronic problem like arthritis can take several
stings per session two to three times per week for up to
three months. Treating MS is a prolonged effort. Those
who have used it say the therapy must happen two to three
times per week for six months in order to start working.

On average, doctors who use the therapy delivered
injections one to two times per week. The number of in-
jections varied widely, from one to 30 per session, de-
pending on the ailment being treated.

Physicians who use the therapy do not use live bees.
Instead, they obtain venom in an injectable form and in-
ject it under the skin.

Obviously, the more stings or injections to be adminis-
tered, the more time the therapy is going to take per session.

Preparations

Before the therapy is begun, a doctor will inject the
patient with a weak form of the venom to test for allergic
reaction. The doctor will have a syringe of epinephrine
nearby in case a reaction does occur. If the patient is al-
lergic to the venom, the therapy cannot be administered.

Lay practitioners and beekeepers who deliver live
stings test patients with an initial sting to the knee or
forearm and observe the patient to see if they are aller-
gic. The test sting should only be administered if the
practitioner has a bee-sting kit containing epinephrine
nearby. If a person is allergic, a reaction will generally
occur in 15 to 20 minutes. Up to 2% of the population
may be allergic to insect venom.

Ice may be used to numb the area where the stings
will occur. It can also be used afterward to soothe the pain.

Precautions

Venom therapy should not be used by those with se-
vere allergies, tuberculosis, syphilis, gonorrhea, and
transient insulin-dependent diabetes.

110

KEY TERMS

Cardiovascular — Refers to the heart and blood
vessels as a unified system.

Multiple sclerosis — A chronic, debilitating disease
that affects the central nervous system causing a
loss of muscular coordination, speech defects,
and the like.

Propolis — A brownish, waxy substance that bees
collect from the buds of certain trees and use to
glue their hives together.

Tendonitis — Refers to an inflammation of the ten-
dons, the fibrous connective tissue that attaches
muscle to bone.

Side effects

Pain, itching, and swelling are common at the injec-
tion or sting site. Patients should also be cautioned that
severe anaphylactic allergic reactions can lead to respira-
tory problems, cardiac collapse, and death. Some may
develop nodular masses or ulcers at sting sites.

It seems, however, that major complications are rare. In
September 1999, it was reported in Patient Care magazine
that Christopher M. H. Kim, director of the Monmouth Pain
Institute in Red Bank, New Jersey, says he has given more
than 34,000 injections to 174 patients over the past 15 years
and has yet to see any major complications. The venom
Kim injects is equivalent to one to ten bee stings. The most
common side effect reported by his patients is itching, re-
ported by 80% of his patients after the first session. After 12
sessions, however, only 40% still experienced itching. Of
his patients, 29.7% reported swelling; 6.4% reported
headache; and 5.6% reported flushing.

Research & general acceptance

Due to a growing body of anecdotal evidence to sup-
port the use of BVT, formal clinical studies were
launched as 2000 approached. The National Multiple
Sclerosis Society has begun funding a study on apithera-
py at Georgetown University Medical Center in Washing-
ton, D.C. The results were expected by the end of 2000.

While the study is ongoing, Joseph A. Bellanti, who
is overseeing the study, has already changed his view of
the therapy. “In the beginning I thought it was rather
strange, but after some investigation, I saw that there are
definite immunologic changes after bee venom therapy,
and the use of venom began to seem less farfetched,” he
told Patient Care.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Over the years, researchers have experimented with
the therapy on animals and have found that bee venom
can keep arthritis at bay in rodents. A study was de-
scribed in RN in which researchers induced a condition
similar to rheumatoid arthritis in rats and found that
daily injections of bee venom suppressed the disease.

Harvard Medical School professor John Mills, who
works with arthritis patients, told Country Journal that he
has seen patients achieve short-term relief through the
sting therapy, though he does not condone its use. He be-
lieves the same response could be achieved through drug
therapy without the allergic risk the venom poses to some.

While animal studies, preliminary results of clinical
trials, and anecdotal evidence suggest BVT may have
therapeutic effects, until clinical trials on humans are
completed, there is no way to know if the treatment
works. The placebo effect may also be responsible for
some degree of benefit patients achieve.

Training & certification

Some physicians practice BVT, but the majority of
those seeking treatment rely on lay practitioners, bee keep-
ers, themselves, or a partner, who is taught to use the bees.

Those seeking treatment can contact the American
Apitherapy Society to find a practitioner near them.

Resources

PERIODICALS

Cerrato, Paul L. “A Therapeutic Bee Sting?” RN 61, 8 (August
1998): 57-58.

D'Epiro, Nancy Walsh. “Bee Venom for Multiple Sclerosis.”
Patient Care 33, 14 (September 15, 1999): 27-31.
Granstrom. Chris. “Stinging Away the Pain.” Country Journal
23, 5 (September/October 1996): 22-25.

Somerfield, Stanley D. “Bee Venom and Arthritis: Magic,
Myth or Medicine?” New Zealand Medical Journal 99,
800 (April 1986): 281-283.

ORGANIZATIONS

American Apitherapy Society. 5390 Grande Road. Hillsboro, OH
45133. (937) 364-1108. <http://www.apitherapy.org/aas.>

OTHER

“Bee Venom Therapy.” Spectrum Medical Arts. <http://www2.
shore.net/-spectrum/apitherapy.html >

Lisa Frick

Appendicitis

Definition

Appendicitis is an inflammation of the appendix,
which is the worm-shaped pouch attached to the cecum,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

the beginning of the large intestine. The appendix has no
known function in the body, but it can become diseased.
Appendicitis is a medical emergency, and if it is left un-
treated, the appendix may rupture and cause a potentially
fatal infection.

Description

Appendicitis is the one of the most common abdomi-
nal emergencies found in the United States. More males
than females develop appendicitis. It is rare in the elderly
and in children under the age of two. The hallmark symp-
tom of appendicitis is increasingly severe abdominal
pain. Since many different conditions can cause abdomi-
nal pain, an accurate diagnosis of appendicitis can be dif-
ficult. Other conditions can have symptoms similar to ap-
pendicitis, especially in women. These include pelvic in-
flammatory disease, ruptured ovarian follicles, ruptured
ovarian cysts, tubal pregnancies, and endometriosis.
Various forms of stomach upset and bowel inflammation
may also mimic appendicitis.

A timely diagnosis of appendicitis is important, be-
cause a delay can result in perforation, or rupture, of the
appendix. When this happens, the infected contents of
the appendix spill into the abdomen, potentially causing
a serious infection of the abdomen called peritonitis.
Very rarely, the inflammation and symptoms of appen-
dicitis may disappear but recur again later. If appendici-
tis is suspected, the following activities should be avoid,
as they may cause the appendix to rupture:

• consuming food or drink

• taking pain medication, laxatives, or antacids

• the use of a heating pad on the affected area

Causes & symptoms

The causes of appendicitis are not totally under-
stood, but are believed to occur as a result of blockage of
the appendix. This blockage may be due to fecal matter,
a foreign body in the large intestine, cancerous tumors, a
parasite infestation, or swelling from an infection.

The distinguishing symptom of appendicitis is the
migration of pain to the lower right corner of the ab-
domen. The abdomen often becomes rigid and tender to
the touch. The patient may bend the knees in reaction to
the pain. Increased rigidity and tenderness indicate an in-
creased likelihood of perforation and peritonitis. Loss of
appetite is very common, accompanied by a low-grade
fever, and occasionally there is constipation or diar-
rhea, as well as nausea. Unfortunately, these signs and
symptoms may vary widely. Atypical symptoms are par-
ticularly present in pregnant women, the elderly, and
young children.

Ill

Appendicitis

An extracted appendix. (Photograph by Lester V. Bergman,
Corbis Images. Reproduced by permission.)

If bacteria multiply unchecked within the appendix, it
will become swollen and filled with pus, and may eventual-
ly rupture. This produces an inflammation of the lining of
the abdominal wall, or peritonitis, which is a medical emer-
gency. Signs of rupture include the presence of symptoms
for more than 24 hours, a high fever, a distended abdomen,
a high white blood cell count, and an increased heart rate.

Diagnosis

A careful examination is the best way to diagnose
appendicitis. It is often difficult even for experienced
physicians to distinguish the symptoms of appendicitis
from those of other abdominal disorders. The physician
will ask questions regarding the nature and history of the
pain, as well doing an abdominal exam to feel for in-
flammation, tenderness, and rigidity. Bowel sounds will
be decreased or absent. A blood test will be given, be-
cause an increased white cell count may help confirm a
diagnosis of appendicitis. Urinalysis may help to rule out
a urinary tract infection that can mimic appendicitis. In
cases with a questionable diagnosis, other tests, such as a
computed tomography scan (CT) or ultrasound may be
performed to help with diagnosis without resorting to
surgery. Abdominal x rays, however, are not of much
value except when the appendix has ruptured.

112

Patients whose symptoms and physical examination
are compatible with a diagnosis of appendicitis are usu-
ally hospitalized and a surgical exploration of the ab-
domen, called a laparotomy, is done immediately to con-
firm the diagnosis. A normal appendix is discovered in
about 10-20% of patients who undergo laparotomy. Be-
cause of the potential for a life-threatening ruptured ap-
pendix, persons suspected of having appendicitis are
often taken to surgery before the diagnosis is certain. If
the symptoms are not clear, surgery may be postponed
until they progress enough to confirm a diagnosis. Some-
times the surgeon will remove a normal appendix as a
safeguard against appendicitis in the future.

Treatment

Appendicitis must be treated by a surgeon in a hos-
pital setting. However, acupressure can be helpful for
recuperation. One dose of homeopathic phosphorus 30c
can be taken before surgery to help reduce nausea, light-
headedness, and disorientation due to anesthesia. Phos-
phorus 6c can be also taken two to three times in the
hours following surgery. Other appropriate remedies
may include Aconite napellus 30c, Arnica montana 30c,
Gelsemium 6c, and Staphysagria 30c.

Allopathic treatment

The treatment for sudden, severe appendicitis is
surgery to remove the appendix, called an appendecto-
my. An appendectomy may be done by opening the ab-
domen in the standard operating technique, or through
laparoscopy, in which a small incision is made through
the navel. Recovery may be faster with a laparoscopy
than with an ordinary appendectomy. An appendectomy
should be performed within 48 hours of the first appear-
ance of symptoms, to avoid a rupture of the appendix
and peritonitis. Antibiotics are given before surgery in
case peritonitis has already taken hold. If peritonitis is
discovered, the abdomen must also be irrigated and
drained of pus, and then treated with multiple antibiotics
for 7-14 days.

Expected results

Appendicitis is usually treated successfully by ap-
pendectomy. Unless there are complications, the patient
should recover without further problems. The mortality
rate in cases without complications is less than 0.1%.
When an appendix has ruptured, or a severe infection has
developed, the likelihood is higher for complications,
with slower recovery, or death from disease. There are
higher rates of perforation and mortality among children
and the elderly.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Laparotomy — Surgical incision into the loin, be-
tween the ribs and the pelvis, which offers sur-
geons a view inside the abdominal cavity.

Pus — A fluid formed in infected tissue, consisting
of while blood cells and cellular debris.

Prevention

Appendicitis is probably not preventable, although
there is some indication that a diet high in leafy green
vegetables may help prevent appendicitis.

Resources

BOOKS

The Editors of Time-Life Books. The Medical Advisor-: The
Complete Guide to Alternative and Conventional Treat-
ments. Virginia: Time-Life, Inc., 1996.

Lininger, D.C., Skye, editor-in-chief, et al. The Natural Phar-
macy. California: Prirna Health, 1998.

Yamada, Tadataka, ed. et al. Textbook of Gastroenterology.
Philadelphia: J.B. Lippincott, 1995.

PERIODICALS

Van Der Meer, Antonia. “Do You Know the Warning Signs of
Appendicitis?” Parents Magazine (April 1997).

Wagner J.M., et al. "Does This Patient Have Appendicitis?”
JAMA: The Journal of the American Medical Association
276 (1996).

Patience Paradox

Applied kinesiology

Definition

Applied kinesiology (AK) is the study of muscles
and the relationship of muscle strength to health. It in-
corporates a system of manual muscle testing and thera-
py. AK is based on the theory that an organ dysfunction
is accompanied by a specific muscle weakness. Diseases
are diagnosed through muscle-testing procedures and
then treated. AK is not the same as kinesiology, or bio-
mechanics, which is the scientific study of movement.

Origins

AK is based on principles of functional neurology,
anatomy, physiology, biomechanics, and biochemistry as

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

well as principles from Chinese medicine, acupuncture,
and massage. It was developed from traditional kinesiol-
ogy in 1964 by George G. Goodheart, a chiropractor
from Detroit, Michigan. He observed that each large
muscle relates to a body organ. A weakness in a muscle
may mean that there is a problem in the associated
organ. Goodheart found that by treating the muscle and
making it strong again, he was able to improve the func-
tion of the organ as well. For example, if a particular nu-
tritional supplement was given to a patient, and the mus-
cle tested strong, it was the correct supplement for the
patient. If the muscle remained weak, it was not. Other
methods of treatment can be evaluated in a similar man-
ner. Goodheart also found that painful nodules (small
bumps) may be associated with a weak muscle. By
deeply massaging the muscle, he was able to improve its
strength. Goodheart ’s findings in 1964 led to the origin
and insertion treatment, the first method developed in
AK. Other diagnostic and therapeutic procedures were
developed for various reflexes described by other chiro-
practors and doctors. Goodheart incorporated acupunc-
ture meridian therapy into AK after reading the writings
of Felix Mann, M.D.

Goodheart considered AK to be a therapeutic tool
that incorporates feedback from the body. He said that
“applied kinesiology is based on the fact that the body
language never lies.” He felt that the body’s muscles
were indicators of disharmony. Once muscle weakness
has been ascertained, the problem may be solved in a va-
riety of ways. If a practitioner approaches the problem
correctly, he believed, making the proper and adequate
diagnosis and treatment, the outcome is satisfactory both
to the doctor and to the patient.

Benefits

AK is not designed for crisis medicine. For example,
an AK practitioner cannot cure cancer, arthritis, diabetes,
heart disease, or infections. This therapy is designed to
be a part of a holistic approach to preventive medicine.
The goals of AK are to (1) restore normal nerve function,
(2) achieve normal endocrine, immune, digestive, and
other internal organ functions, (3) intervene early in de-
generative processes to prevent or delay pathological con-
ditions, and to (4) restore postural balance, correct gait
(walking) impairment, and improve range of motion.

Description

According to AK, each muscle in the body relates to
a specific meridian or energy pathway (acupuncture
lines) in the body. These meridians also relate to organs
or glands, allowing the muscles to provide information
about organ or gland function and energy. The five areas

113

Applied kinesiology

GEORGE GOODHEART 1918-

Dr. George Goodheart was born in Detroit, Michi-
gan, in 1918 and became a second-generation doctor
of chiropractic. He graduated from the National College
of Chiropractic in 1939 and is recognized as the
founder and developer of applied kinesiology. After he
joined the U.S. Air Force as an aviation cadet in World
War II, he received a promotion to major at the age of
22. He was the youngest ever to attain that rank. He
served in active duty from 1941-1946 and continued as
a member of the Air Force Reserve until the mid-1 950s.

Goodheart held numerous positions of distinction
during his career, including director of the National
Chiropractic Mutual Insurance Company and director
for the International College of Applied Kinesiology-
U.S.A. He also lectured and taught throughout the Unit-
ed States, Japan, Europe, and Australia; and he was the
official doctor of chiropractic for the Lake Placed Win-
ter Olympic Games in 1980. He contributes to a variety
of trade publications on a regular basis.

In 1998 Goodheart received a Lifetime Achieve-
ment Award from the International College of Kinesiolo-
gy. Earlier, in 1987 he was honored with the Leonardo
da Vinci Award from the Institute for the Achievement of
Human Potential, and he was cited for his research by
Logan and Palmer Colleges of Chiropractic. He repre-
sented the State of Michigan as a delegate to the Ameri-
can Chiropractic Association and was a fellow at the In-
ternational College of Chiropractic. He resides with his
wife, JoAnn in Grosse Pointe Woods, Michigan, where
he enjoys skiing and tennis.

Gloria Cooksey

of diagnosis and therapy for the applied kinesiologist are
(1) the nervous system, (2) the lymphatic system, (3) the
vascular (blood vessel) system, (4) the cerebrospinal sys-
tem, and (5) the meridian system.

The first part of AK is muscle testing, which is used
to help diagnose what part of the body is functioning ab-
normally. Muscle testing involves putting the body into a
position that requires a certain muscle to remain contract-
ed, and then applying pressure against the muscle. The
testing does not measure strength but is meant to reveal
stresses and imbalances in the body through the tension
in the muscle. The test evaluates the ability of a control-
ling system (like the nervous system) to adapt the muscle
to meet the changing pressure of the examiner’s test. AK
practitioners also examine structural factors such as pos-
ture, gait, and range of motion. Some chiropractors use
AK to help them evaluate the success of spinal adjust-

114

ment. A leg muscle is tested for strength or weakness to
determine whether the adjustments made are appropriate.

According to AK, common internal causes of mus-
cle weakness include;

• dysfunction of nerve supply (nerve interference be-
tween spine and muscles)

• impairment of lymphatic drainage

• reduction of blood supply

• abnormal pressure in cerebral fluid affecting nerve-to-
muscle relationships

• blockage of an acupuncture meridian

• imbalance of chemicals

• dysfunction of organs or glands

• excesses or deficiencies in nutrition

Physiological reactions to chemicals, including
those associated with nutrition and allergies, may also
be evaluated using AK. The AK protocol for testing
chemical compounds is to place the substance on the pa-
tient’s tongue so that he tastes the material, and the nor-
mal chemical reactions of ingestion begin. In some
cases, the substances are inhaled through the nose. The
AK practitioner then tests the associated muscle-organ
pattern to determine where or if there is a strength or
weakness. The patient does not need to swallow the sub-
stance for a change in strength or weakness to be identi-
fied. David S. Walther, a diplomate of the International
College of Applied Kinesiology, has indicated that “it is
possible that the central nervous system, recognizing the
compound being ingested, relays information to the or-
gans and glands preparing for use of the compound. If
the compound is recognized as beneficial, the energy
pattern is immediately enhanced, influencing not only
the organ or gland, but also the associated muscle.”

AK has been used as a diagnostic health tool for a
variety of conditions.

Bone health

• neck/low back pain and sciatica

• whiplash

• frozen shoulder

Joint health

• carpal tunnel syndrome

• arthritis (including rheumatoid arthritis)

• sports injuries

Muscle health

• tennis elbow

• heel spurs

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

wound healing

intermittent claudication (pain on walking)

restless legs

cramps

Vascular system health
aching varicose veins
palpitations
high blood pressure
Nervous system health
migraine and other headaches
trigeminal neuralgia and other face pains
Bell’s palsy
anxiety
depression
fears

addictions (like smoking)

claustrophobia

Meniere’s disorder

neuralgia (severe, throbbing pain)

travel sickness

fatigue

phantom limb pain
paralysis of leg or arm after a stroke
Respiratory system health
hay fever

rhinitis (inflammed nasal passages)

asthma

bronchitis

emphysema (lung disease)

Urinary system health

cystitis (bladder inflammation), especially in the elderly
early prostate enlargement

non-specific urethritis (inflammation of tube from the
bladder)

bedwetting

Reproductive organ health
menstrual pains

irregular or excessive menstrual activity
pelvic pains and endometriosis
menopausal flushes
painful, nodular breasts

• preparation for childbirth

• vaginal pain

• post herpetic (shingles) pain

• impotence and infertility

Skin health

• pain after operations

• painful, prominent scars

• wrinkles or bagginess of face

• acne

• psoriasis and eczema (skin diseases)

• boils

• excessive perspiration

• hemorrhoids

• canker sores

• itching

Immune system health

• recurring tonsillitis (inflammed tonsils)

• persisting weakness after a severe illness

Sensory organ health

• tinnitus (ringing ears)

• tired eyes

• retinitis pigmentosa and pterygium retinitis (diseases of
the retina)

Digestive system health

• constipation

• colitis or other bowel inflammations

• ulcers

• diarrhea

• obesity

The second part of AK involves the treatment phase.
Goodheart and other practitioners of AK have adapted
many treatment methods for the problems that are diag-
nosed with muscle testing. Examples of treatment meth-
ods include special diets, dietary supplements, chiro-
practic manipulation, osteopathic cranial techniques,
acupuncture/meridian therapies, acupressure, deep mus-
cle massage, and nervous system coordination proce-
dures. For example, an AK practitioner might treat asth-
ma by looking for weaknesses in specific lower back and
leg muscles that share a connection with the adrenal
glands. The practitioner will strengthen these muscles
and help the adrenal gland produce bronchodilators,
chemicals that relax or open air passages in the lungs.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

115

Applied kinesiology

The practice of kinesiology requires that it be used
in conjunction with other standard diagnostic methods
by professionals trained in clinical diagnosis. Most prac-
titioners of AK are chiropractors, but naturopaths, med-
ical doctors, dentists, osteopaths, nutritionists, physical
therapists, massage therapists, podiatrists, psychiatrists,
and nurse practitioners are also involved. In 1991, 37.2%
of 4,835 full-time chiropractors in the United States who
responded to a survey by the National Board of Chiro-
practic Examiners (NBCE) said they used AK in their
practice. Subsequent NBCE surveys indicated that 31%
of chiropractors in Canada, 60% in Australia, and 72% in
New Zealand use AK.

Most practitioners of AK utilize a holistic approach
and evaluate a person from a triad-based health perspec-
tive. Generally, chiropractors approach health and heal-
ing from a structural basis, medical doctors generally
from a chemical basis, and psychiatrists and psycholo-
gists from a mental or emotional basis. Applied kinesiol-
ogists attempt to work with all three areas of health, and
in some cases, include a spiritual dimension.

The use of AK is often included in insurance cover-
age if the policy covers chiropractor benefits. The cost of
the AK examination is similar to the costs of other chiro-
practic practices.

Preparations

Since AK is a non-invasive diagnostic tool, there are
no preparations required.

Precautions

AK should only by used by trained professionals
with the necessary expertise to perform specific and ac-
curate tests. The AK examination should be combined
with a standard physical diagnosis, which often includes
laboratory tests, x rays, health and dietary history, and
other special tests. An AK examination should enhance a
standard diagnosis, not replace it. The total diagnostic
work-up should be used to determine the final diagnosis.

The use of manual muscle testing to evaluate nutri-
tion is particularly a problem if it is done by a lay nutri-
tion sales person as a tool to sell his/her product. The per-
son should have the educational background to evaluate
nutritional needs as well as have a high level of knowl-
edge in the use of proper muscle testing techniques.

Side effects

If AK is performed by a trained practitioner with the
appropriate educational background, side effects from
the muscle-testing procedures should be minimal.

116

Research & general acceptance

AK is a tool that is used by many health care profes-
sionals, and especially by chiropractors. A literature re-
view published in 1999 by researchers from the School
of Medicine at the University of North Carolina at
Chapel Hill and the Foundation for Allied Conservative
Therapies Research in Chapel Hill stated that, although
AK appears to be a promising methodology, there is a
lack of research results relevant to clinical practice and
outcomes of AK care. They found this lack of results
surprising, since cost, satisfaction, utilization, and
changes in symptoms are the important results of clinical
practice. In addition, they determined that some studies
that were supposed to be an evaluation of AK procedures
did not actually use clinical practices and principles of
AK. However, from studies adhering to AK principles
and employing standardized training by well-trained
practitioners, they did state there was some evidence that
AK is an objectively verifiable phenomenon. They sug-
gested that “future studies of AK should focus on out-
comes of care, including symptoms, function, costs, and
safety. Only well-designed studies that account for the
individual nature of AK diagnosis and treatment and pre-
serve the proper clinical context of AK treatment will be
informative. Understanding the individual components
of the process of AK treatment remains important. Stud-
ies addressing validation of isolated AK procedures need
to meet the methodological challenges of studying ap-
propriate subjects that reflects the current recognized
practice and understanding of AK. Further evaluation of
the basic physiologic phenomena involved and correla-
tion of AK manual muscle test results will also advance
understanding of this diagnostic and therapeutic system.”

Training & certification

In 1976, a group of doctors who were practicing AK
founded the International College of Applied Kinesiology
(ICAK). The purpose of the ICAK is to promote teaching
and research of AK. The college does not have physical
buildings. Instead, it is an organization to bring together
those in the health field with common interests and goals
and to provide education in the use of AK. The organiza-
tion has chapters representing Belgium, Luxembourg,
and the Netherlands (BeNeLux), Germany, France, Italy,
Germany, Scandanavia, United Kingdom, Canada, Aus-
tralia and Asia (Australasia), and the United States.

AK is performed by a healthcare professional who
has basic education in his or her field of practice. To be-
come an applied kinesiologist, the healthcare profession-
al must study the principles in a basic course, which in-
cludes 100 hours of classroom study taught by a diplo-
mate of the ICAK. At the end of this course, students

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

take a basic proficiency test. To obtain certification by
the board of ICAK, the professional must complete 300
hours of continuing classes, pass a diplomate test (a
comprehensive written and practical test), and present
two research papers to the general membership of ICAK.

Resources

BOOKS

Holdway, Anne. Kinesiology: Muscle Testing and Energy Bal-
ancing for Health and Well-Being. Rockport, MA: Ele-
ment, 1997.

Valentine, Tom, Carol Valentine, and D.P. Hetrick. Applied Ki-
nesiology. Rochester, VT: Healing Arts Press, 1989.

ORGANIZATIONS

International College of Applied Kinesiology. 6405 Metcalf Ave„
Suite 503, Shawnee Mission, KS 66202. 913-384-5336.
<http://www.icakusa.com and http://www.icak.com>

Judith Sims

Apricot seed

Description

Apricot seed is the small kernel enclosed within the
wood-like pit at the center of the apricot fruit. The apri-
cot tree carries the botanical name Primus armeniaca. It
is a drupe, meaning stone-fruit, and a close relative of
the peach. Both are very similar in appearance and quali-
ties. The apricot is also sometimes called apricock or Ar-
meniaca vulgaris. Like the plum, both peaches and apri-
cots are distantly related to the rose and are classified as
members of the Rosacaeae family.

Apricots grow on small to medium size trees, which
are hardy in most temperate areas. White, multi-petaled
blossoms with a slight reddish tinge nearer to the base of
the flower emerge onto the bare branches in early spring,
before the tree's heart-shaped leaves appear. By late July
or early August, the apricot fruit ripens. There are more
than 20 varieties of apricot known to botanists.

The name Primus armeniaca is actually a misnomer
based upon the long-held belief that apricots initially came
from Armenia. It is now known that in reality they originat-
ed in the Far East, most likely in the Himalayas and North-
ern China. It is speculated that the apricot had already mi-
grated to the Middle East before the Old Testament and that
the apples described in the Garden of Eden in Genesis were
actually apricots. During the reign of King Henry VIII in
the 1500s, apricots were brought to England from Italy.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Though smaller than the peach, apricots have the
same russet-tinted, golden, velvet appearing exterior and
deeper golden-orange flesh inside. The innermost layers
form the large, woody compressed stone, or pit, that con-
tains at its very center, the kernel, or seed. When pressed,
nearly half of this kernel gives forth an oil very chemi-
cally similar to the oil found in sweet almond and peach
kernels. This oil contains olein, glyceride of linoleic
acid, and a transparent, crystalline chemical compound,
amygdalin, or laetrile. This compound is also known as
vitamin B 17 . The oil is chemically indistinguishable from
oil of bitter almond. Although the oil from apricot seeds
usually breaks down into a toxic substance capable of
causing death within the human body, there are also vari-
eties of apricot seed that are reported to be edible.

General use

Because the oil from the apricot seed is far less ex-
pensive than oil of almond, confectioners use it in place of
bitter almond oil for flavoring sweets and as a culinary
seasoning. A liqueur manufactured in France is made
from apricot seed and is called Eau de Noyaux. Apricot oil
is also used extensively in the manufacture of cosmetics,
often being fraudulently added to almond oil. It has skin
softening properties and is often used in making soaps,
hand creams, cold cream, and perfume preparations.

Chinese Medicine practitioners use apricot seed as a
treatment in respiratory diseases, including bronchitis
and emphysema. It is believed to act as an cough sup-
pressant and expectorant and, because of the oil, also
used as a laxative.

There has been considerable controversy regarding
apricot seed, and specifically amygdalin, one of its com-
ponents. Since the 1920, in many countries around the
globe it has been recognized as a possible cancer preven-
tative and malignant cell growth inhibitor. In San Francis-
co, biochemist Ernst Krebs’s article The Nitrilosides ( Vit-
amin B 17 )-Their Nature , Occurrence and Metabolic Sig-
nificance (Antineoplastic Vitamin B I7 ) theorized that
amygdalin, with diet and vitamins, could inhibit cancer-
ous growths. In the years since, it has been used in many
countries as a cancer treatment, thought to be especially
beneficial in the treatment of smoking-related tumors
such as lung cancer. Several studies done in the United
States throughout the 1970s and early 1980s demonstrat-
ed that amygdalin did not kill cancer cells. Review of pa-
tients’ records where there had been reported cures or re-
markable size reduction in tumors did not provide credi-
ble evidence of amygdalin ability to treat cancer effec-
tively. There has been significant documentation that
amygdalin breaks down into cyanide, a potent poison, in

117

Apricot seed

Arginine

KEY TERMS

Expectorant — An agent that facilitates the removal
of the secretions of the bronchopulmonary mu-
cous membrane.

Unapproved drug — The FDA is responsible for en-
suring that biological products are safe and effec-
tive and in compliance with the law and FDA reg-
ulations. Biological products are licensed under
the provisions of Section 351 of the Public Health
Service Act (42USCKPHS Act).

the human body, and when taken in sufficiently high
doses, can actually bring on death due to its toxicity.

Preparations

Apricot seed is not sold in American health food
stores due to its classification as an unapproved drug by
the U.S. Food and Drug Administration. However, it is
available in other countries, including Mexico, and in
Chinese pharmacies and Asian markets. It is sold both as
the whole kernel or seed, or in decoctions including
cough syrups. Chinese practitioners usually combine
apricot seed with other herbs, including white mulberry
leaf or ophiopogon, a tuber grown in Asia. A paste made
of apricot seed and sugar has been shown, in some Chi-
nese medical trials, to relieve chronic bronchitis.

Precautions

As noted previously, the amygdalin in apricot seed
breaks down within the body into a form of the deadly
poison cyanide, or prussic acid. There has been consider-
able debate concerning its level of toxicity to human be-
ings. Following an Oklahoma judicial decision legalizing
the importation of amygdalin in 1986, clinical trials were
begun by the FDA and National Cancer Institute in 1987.
Amygdalin was used, along with the diet, enzymes, and
vitamins suggested by pro-amygdalin factions. The re-
port from this study concludes: “No substantive benefit
was observed in terms of cure, improvement, or stabi-
lization of the cancer.’’ They further reported that “the
hazards of amygdalin therapy were evidenced in several
patients by symptoms of cyanide toxicity or by blood
cyanide levels approaching lethal range. Amygdalin is a
toxic drug that is not effective as a cancer treatment.” It
has been reported that ten apricot seeds can kill a child.

Side effects

Chinese practitioners caution using apricot seed if the
person being treated suffers from diarrhea. Headache

118

and nausea have been reported following ingestion of
small amounts. The most serious side effect of apricot
seed is potential cyanide poisoning. When large doses of
cyanide are ingested, death is almost instantaneous. Toxic-
ity from smaller doses is manifested by vomiting, diar-
rhea, mental confusion, vertigo, headache, extreme dysp-
nea, and violent respirations, slow pulse, weakness, glassy
or protruding eyes, dilated pupils, and a characteristic
(peach blossoms, bitter almond) odor to the breath.

Interactions

Practitioners of Chinese medicine advise that apri-
cot seed should not be given in combination with the
herbs astragalus, skullcap, or kudzu root.

Resources

BOOKS

Carper, Jean. The Food Pharmacy. Bantam Books, 1988.
Grieve, M. and C. F. Leyel. A Modern Herbal: The Medical,
Culinary, Cosmetic and Economic Properties, Cultivation
and Folklore of Herbs, Grasses, Fungi, Shrubs and Trees
With All of Their Modern Scientific Uses. Barnes & Noble
Publishing, 1992.

Holvey, David N., MD. Merck Manual. Sharp & Dohme Re-
search Laboratories, 1972.

Taber, Clarence Wilbur. Taber's Cyclopedic Medical Dictio-
nary. F.A. Davis Co.

PERIODICALS

Krebs, Ernst T., Jr. “The Nitrilosides (Vitamin B-17)-Their Na-
ture, Occurence and Metabolic Significance Antineoplas-
tic Vitamin B- 17).” Journal of Applied Nutrition 1970.

ORGANIZATIONS

U.S. Food and Drug Administration. HFI-40, Rockville, MD
2085.1-888-463-6332. webmail@oc.fda.gov. http://www.
fda.gov/bbs/topics/ANSWERS/ANS00309.htm.

Joan Schonbeck

Arbor vitae see Thuja

Arginine

Description

Arginine is one of the amino acids produced in the
human body by the digestion, or hydrolysis of proteins.
Arginine can also be produced synthetically. Because it
is produced in the body, it is referred to as “nonessen-
tial,” meaning that no food or supplements are necessary
for humans to ingest. Arginine compounds can be used
in treating people with liver dysfunction due to its role in
promoting liver regeneration.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

General use

In March 2000 in Newsweek magazine, Stephen
Williams noted the newly discovered role arginine might
play in treating people with chronic heart failure (CHF).
The study, as reported in the Journal of the American Col-
lege of Cardiology involved 40 patients who suffered from
CHF. Rainer Hambrecht and colleagues from the Univer-
sity of Leipzig in Germany did the research by dividing
the group into four sections. One group took 8 g of argi-
nine daily for four weeks. A second took no supplement,
but did daily forearm exercises. The third did both the ex-
ercises, and took the supplement daily. The fourth group
was a control group and did nothing except taking their
usual medication, as did the others. Because of the known
fact that arginine is naturally converted into nitric oxide by
the human body, the result of that chemical relaxing blood
vessels was also known when the experiment began. The
group that took the arginine alone showed an improve-
ment in their blood-vessel dilation by four times, as did
the group doing exercises alone. The third who did both,
showed an increase six times better than the original
blood-dilation factor. Promise in the future use of arginine
in treating heart patients with this condition was indicated
as researchers continued to perform further tests. Accord-
ing to an article by Liz Brown written in Better Nutrition
in June 2000, also discussing the Leipzig study, “Numer-
ous other studies have shown that arginine has a vadodila-
tory effect on people with high cholesterol levels, those
with high blood pressure and others with compromised
circulation associated with heart disease.”

Other research in the use of arginine has indicated
that arginine is crucial to the wound-healing process,
particularly in the elderly for whom blood circulation is
poor. Arginine is necessary for growth periods but not
for body maintenance.

Benefits of the use of arginine as a supplement include:

• improves immune response to bacteria, viruses, and
tumor cells.

• promotes wound healing by repairing tissues

• plays a crucial role in the regeneration of liver

• responsible for release of growth hormones

• promotes muscle growth

• improves cardiovascular functioning

Arginine is used as a supplement in the treatment of
heart patients with arterial heart disease; as an intra-
venous supplement to patients with liver dysfunction; as
a supplement for easing exercise-related pains due to the
heart muscle not getting enough blood to circulate to the
muscles in the calves. Supplements that combine argi-
nine with other amino acids, such as ornithine and

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

lysine, are purported to assist in muscle-building exercis-
es by minimizing body fat and maximizing muscle tone.
Results vary among those who have taken these supple-
ments. Arginine is also present in “multi” amino acids
capsules that are taken as a dietary supplement.

New information released in 2002 showed that treat-
ment with arginine improved immune function in HIV
patients and proved safe for these patients when used on
a short-term patients. Other new research was finding
that arginine supplements worked as an effective antico-
agulant, but unlike aspirin and other anticoagulants,
could prevent clotting without increasing stroke risk.
New research also is showing arginine’s effectivenss in
fighting cancer and protecting and detoxifying the liver,
improving male fertility, and promoting healing.

Preparations

Arginine supplements as an alternative medicine
therapy are normally taken in either tablet or capsule
form. In naturopathic treatment of liver dysfunction, the
supplement would be added intravenously as a powder
diluted in liquid. Discoveries reported in 2000 indicated
that in the treatment of arterial heart disease, the inges-
tion of arginine tablets or capsules of 6-9 g a day are
helpful in dilating blood vessels to ease circulation and
prevent the buildup of cholesterol.

Precautions

Long-term effects of arginine supplements have not
yet been determined. Consultation with a physician re-
garding individual needs is always advised. Individuals
who attempt to treat their own heart ailments, or intend
to guard against any potential difficulty, should seek ad-
vice of a physician. Arginine does not show any positive
results in treatment of men with damaged valves or en-
larged heart tissue.

Arginine has been suspected in the formation of cold
sores. Some practitioners suggest that consuming foods
high in arginine, such as nuts, grains, and chocolates, can
promote cold sores. Reducing intake of foods high in
arginine and increasing intake of lysine (another amino
acid) can reduce or even eliminate the cold sore problem.

Side effects

As previously noted, the use of supplemental argi-
nine should be monitored for use with specific problems.
Overdose could result in unforeseen complications,
while regular use might or might not help ease everyday
problems, such as relaxation of muscles not due to the
specific heart ailment of arterial disease. People who
should not take arginine supplements are those predis-

119

Arginine

Arnica

posed to herpes outbreaks; cancer patients, due to possi-
ble increase in cell replication of cancerous cells; those
with low blood pressure; and individuals with certain
liver or kidney problems. Those taking blood thinners
are advised to seek medical advice before taking the sup-
plement. Pregnant women are also cautioned against tak-
ing the supplements due to the unknown affect it could
have on both mother and child.

Interactions

Long-term studies are ongoing. While no adverse re-
actions of ordinary supplements of 6-9 g a day have yet
been documented, caution is urged. Because amino acids
are not drugs, their use is not regulated by the U.S. Food
and Drug Administration (FDA). One study in April 1999
in Healthlnform: Essential Information on Alternative
Health Care reported that nutritional supplements of argi-
nine with omega-3 fatty acids for outpatients with HIV
showed no particular benefits in immunity.

Resources

PERIODICALS

“Arginine Treatment man Improve Immune Function.” AIDS
Weekly (September 23, 2002):3.

Brown, Edwin W. “Troubled by Cold Sores?” Medical Update
(March 1999).

Brown, Liz. “Arginine and Exercise." Better Nutrition ( June
2000 ).

Chowienczyk, Phil and Jim Ritter. “Arginine: NO more than a
simple amino acid?” The Lancet 27 (September 1997).
Gerard, James M. and Atchawee Luisiri. “A fatal overdose of
arginine hydrochloride.” Journal of Toxicology (Novem-
ber 1997).

Henderson, Charles W. “Suppression of Arginine Transport and
Nitric Oxide Synthesis in Activated Macrophages by Cat2
Antisense Oligonucleotides.” Cancer Weekly Plus (28 De-
cember 1998).

Klotter, Jule. “Arginine and Heart Disease.” Townsend Letter
for Doctors and Patients (August-September 2002): 22.
Marandino, Cristin. “Taking Heart.” Vegetarian Times (Novem-
ber 1999).

Pessarosa, A.; Dazzi. D.; Negro, C.; Cebigni, C.; Vescovi, P. P.
“Effects of Alcohol Consumption and Accompanying Diet
on Metabolic Response to Arginine in Chronic Alco-
holics.” Journal of Studies on Alcohol (September 1999).
“Prospective Study tests Nutritional Supplements enriched
with Arginine and Omega-3 Fatty Acids.” Healthlnform:
Essential Information on Alternative Health Care (April
1999).

Rodale Press. “Bypass This Snack." Men's Health (November
1999).

Rodale Press. "Is Being Henpecked Hereditary?" Mens Health
(January 2000).

Thomas, Clayton, L., M.D., M.P.H., ed. “Hyperkalemia.” Taber’s
Cyclopedic Medico Dictionary. Edition 13 Philadelphia: F.
A. Davis Company, 1977.

120

KEY TERMS

Hyperkalimia — Excessive amount of potassium in
the blood that serves as an indicator of the possi-
ble serious complications in bodily functions.

Webb, Denise. “Ease Exercise-Related Pains with Arginine.”
Prevention December 1999.

Williams, Stephen. “Passing the Acid Test.” Newsweek 27
March 2000.

OTHER

“Arginine.” Mosby’s Medical. Nursing & Allied Health Dictio-
nary, Edition 5 1998. Available from <http://web2.infotrac.
galegroup.com/itw.>

Jane Spehar
Teresa G. Odle

Arnica

Description

Arnica ( Arnica montana L.), known also as leopards-
bane, wolfsbane, and European arnica, is a member of the
Compositae (Asteraceae) family. This attractive herb is
native to the mountains of Siberia and central Europe,
where the leaves were smoked as a substitute for tobacco.
This practice led to a common name for the herb: moun-
tain tobacco. There are several North American species of
arnica, including A. fulgens, A. sororia, and A. cordifolia.
Arnica thrives in the northern mountains of the United
States and Canada, in high pastures and woodlands.

Arnica grows from a cylindrical, hairy rhizome with a
creeping underground stem. First year leaves are downy
and grow in a flat rosette at the base of the stem. In the sec-
ond year, arnica sends up a round, hairy stem with smaller,
sessile leaves growing in one to three opposite pairs. This
central stem may branch into three or more stems each
with a terminal composite blossom. Arnica’s aromatic,
daisy-like flowers have 10-14 bright yellow rays, each
with three notches at the end. Flower rays are irregularly
bent back. The central disk is composed of tubular florets.
Arnica blooms from June to August. The flowerheads,
when crushed and sniffed, may cause sneezing, resulting
in another of arnica’s common names: sneezewort.

History

Arnica has a history of folk medicine use in many lo-
cations, including North America, Germany, and Russian.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

The herb has been used in folk remedies since the six-
teenth century. A North American indigenous tribe, the
Cataulsa, prepared a tea from arnica roots to ease back
pains. The German writer Goethe credited arnica with
saving his life by bringing down a persistent high fever.
Arnica preparations are used extensively in Russia. Folk
use there includes external treatment of wounds, black
eye, sprains, and contusions. Arnica has been used in
Russian folk medicine to treat uterine hemorrhage, my-
ocarditis, arteriosclerosis, angina pectoris, cardiac insuf-
ficiency, and in numerous other unproven applications.

General use

Arnica flowers, fresh or dried, are used medicinally.
Many herbalists consider arnica to be a specific remedy
for bruises, sprains, and sore muscles. The herb is known
by some as “tumbler’s cure all,” reflecting this common
medicinal use. A compress soaked in an arnica infusion
may relieve the inflammation of phlebitis. A few drops of
arnica tincture added to warm water in a foot bath will re-
lieve fatigue and soothe sore feet. A hair rinse prepared
with arnica extract has been used to treat alopecia neuroti-
ca, an anxiety condition leading to hair loss. The very di-
lute homeopathic preparation ingested following a shock
or muscle/soft tissue trauma is said to be beneficial. The
homeopathic preparation is also used to relieve vertigo,
hoarseness, and seasickness. Studies have determined that
arnica has properties that act as an immunostimulant. The
extract of arnica has been shown to stimulate the action of
white blood cells in animal studies, increasing resistance
to bacterial infections, such as salmonella.

German studies have isolated sesquiterpenoid lac-
tones, including helenalin and dihydrohelenalin, in arni-
ca. These compounds were found to possess the pharma-
cologic properties responsible for arnica’s anti-inflamma-
tory and analgesic effects. Arnica contains sesquiterpene
lactones, flavonoid glycosides, alkaloid, volatile oil, tan-
nin, and isomeric alcohol, including arnidio and foradiol.

Arnica is approved for external use as an anti-in-
flammatory, analgesic, and antiseptic by the German
Commission E, an advisory panel on herbal medicines.
There are over one hundred medicinal preparations using
arnica extracts commercially available in Germany. In
the United States, arnica is widely used in topical appli-
cation for bruises, aches, sprains, and inflammations. Ar-
nica was listed in the U.S. Pharmacopeia from the early
1800s until 1960.

Preparations

Arnica is available commercially in the form of lini-
ments and massage oil for external application, and in

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

very dilute homeopathic preparations considered safe for
internal use.

Harvest fully open arnica blossoms throughout the
flowering season. Pick the flower heads on a sunny day
after the morning dew has evaporated. Spread the blos-
soms on a paper-lined tray to dry in a bright and airy room
away from direct sun. Temperature in the drying room
should be at least 70°F (21.1°C). When the blossoms are
completely dry, store in a dark glass container with an air-
tight lid. The dried herb will maintain medicinal potency
for 12-18 months. Clearly label the container with the
name of the herb and the date and place harvested.

Tincture: Combine four ounces of fresh or dried ar-
nica flowers with one pint of brandy, gin, or vodka in a
glass container. The alcohol should be enough to cover
the flowers. The ratio should be close to 50/50 alcohol to
water. Stir and cover. Place the mixture in a dark cup-
board for three to five weeks. Shake the mixture several
times each day. Strain and store in a tightly capped,
clearly labeled, dark glass bottle. Tinctures, properly pre-
pared and stored, will retain medicinal potency for two
years or more. Arnica tincture should not be ingested
without supervision of a qualified herbalist or physician.

Ointment: Simmer one ounce of dried and powdered
arnica flowers with one ounce of olive oil for several
hours on very low heat. Combine this medicinal oil with
melted beeswax to desired consistency. Pour into dark
glass jars while still warm. Seal with tightly fitting lids
when cool and label appropriately.

Infusion: Place two to three teaspoons of chopped,
fresh arnica blossoms in a warmed glass container. Bring
two cups of fresh, nonchlorinated water to the boiling
point, add it to the herbs. Cover. Simmer for about 10
minutes. Strain. The prepared tea will store for about two
days in the refrigerator. The infusion may be used to
bathe unbroken skin surfaces and to provide relief for
rheumatic pain, chillbains, bruises, and sprains. Because
of the toxicity of arnica, it is best to avoid internal use
without qualified medical supervision.

Precautions

Arnica is deadly in large quantities. Do not ingest
the herb or the essential oil. Do not use the undiluted es-
sential oil externally. The extremely dilute homeopathic
preparation of arnica is considered safe for internal use
in proper therapeutic dosages. Overdose of arnica extract
has resulted in poisoning, with toxic symptoms, such as
vomiting, diarrhea, and hemorrhage, even death. Use
externally with caution, and only in dilute preparations.
Only the homeopathic tincture can be safely ingested.
Discontinue if a skin rash results, and do not use on bro-
ken skin. Research has confirmed that alcoholic extracts

121

Arnica

Aromatherapy

of arnica have a toxic action on the heart, and can cause
an increase in blood pressure.

Side effects

Arnica contains a compound known as helenalin, an
allergen that may cause contact dermatitis in some per-
sons. If a rash develops discontinue use of the herbal
preparation. Prolonged external use of arnica extract in
high concentrations can result in blistering, skin ulcers,
and surface necroses.

Interactions

None reported.

Resources

BOOKS

Elias, Jason and Shelagh Ryan Masline. The A to Z Guide to
Healing Herbal Remedies. Lynn Sonberg Book Associ-
ates, 1996.

Hoffmann, David. The New Holistic Herbal. 2d ed. Massachu-
setts: Element, 1986.

Kowalchik, Claire and William H. Hylton. Rodale's Illustrated
Encyclopedia of Herbs. Pennsylvania: Rodale Press,
1987.

Lust, John. The Herb Book. New York: Bantam Books, 1974.

Magic And Medicine of Plants. The Reader's Digest Associa-
tion, Inc. 1986.

Meyer, Joseph E. The Herbalist. Clarence Meyer, 1973.

Palaise, Jean. Grandmother’ s Secrets. Her Green Guide to
Health From Plants. NY: G.P. Putnam's Sons, 1974.

PDRfor Herbal Medicines. New Jersey: Medical Economics
Company, 1998.

Phillips, Roger and Nicky Foy. The Random House Book of
Herbs. New York: Random House, Inc., 1990.

Thomson, M.D., William A. R. Medicines From The Earth, A
Guide to Healing Plants. San Francisco: Harper & Row,
1978.

Tyler, Varro E., Ph.D. Herbs Of Choice, The Therapeutic Use
of Phytomedicinals. New York: The Haworth Press, Inc.,
1994.

Tyler, Varro E., Ph.D. The Honest Herbal. New York: Pharma-
ceutical Products Press, 1993.

OTHER

Grieve, Mrs. M. A Modern Herbal, Arnica, <http://botanical.com/
botanical/mgmh/a/amic058.html.>

Hoffmann, David L. Herbal Materia Medica, Hyssop. <http://
www.healthy.net.>

Clare Hanrahan

122

Aromatherapy

Definition

Aromatherapy is the therapeutic use of plant-de-
rived, aromatic essential oils to promote physical and
psychological well-being. It is sometimes used in combi-
nation with massage and other therapeutic techniques as
part of a holistic treatment approach.

Origins

Aromatic plants have been employed for their heal-
ing, preservative, and pleasurable qualities throughout
recorded history in both the East and West. As early as
1500 B.c. the ancient Egyptians used waters, oils, in-
cense, resins, and ointments scented with botanicals for
their religious ceremonies.

There is evidence that the Chinese may have recog-
nized the benefits of herbal and aromatic remedies much
earlier than this. The oldest known herbal text, Shen
Nung's Pen Ts’ao (c. 2700-3000 B.c.) catalogs over 200
botanicals. Ayurveda, a practice of traditional Indian
medicine that dates back more than 2,500 years, also
used aromatic herbs for treatment.

The Romans were well known for their use of fra-
grances. They bathed with botanicals and integrated them
into their state and religious rituals. So did the Greeks,
with a growing awareness of the medicinal properties of
herbs. Greek physician and surgeon Pedanios Dioscorides,
whose renown herbal text De Materia Medica (60 a.d.)
was the standard textbook for Western medicine for 1,500
years, wrote extensively on the medicinal value of botani-
cal aromatics. The Medica contained detailed information
on some 500 plants and 4,740 separate medicinal uses for
them, including an entire section on aromatics.

Written records of herbal distillation are found as
early as the first century a.d., and around 1000 a.d., the
noted Arab physician and naturalist Avicenna described
the distillation of rose oil from rose petals, and the medi-
cinal properties of essential oils in his writings. Howev-
er, it wasn't until 1937, when French chemist Rene-Mau-
rice Gattefosse published Aromatherapie : Les Huiles es-
sentielles, hormones vege tales, that aromatherapie, or
aromatherapy, was introduced in Europe as a medical
discipline. Gattefosse, who was employed by a French
perfumeur, discovered the healing properties of lavender
oil quite by accident when he suffered a severe burn
while working and used the closest available liquid,
lavender oil, to soak it.

In the late twentieth century, French physician Jean
Valnet used botanical aromatics as a front line treatment

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

AROMATHERAPY OILS

Name

Description

Conditions treated

Bay laurel

Antiseptic, diuretic, sedative, etc.

Digestive problems, bronchitis, common cold, influenza,
and scabies and lice. CAUTION: Don't use if pregnant.

Clary sage

Relaxant, anticonvulsive,
antiinflammatory, and antiseptic

Menstrual and menopausal symptoms, burns, eczema, and
anxiety. CAUTION: Don't use if pregnant.

Eucalyptus

Antiseptic, antibacterial, astringent,
expectorant, and analgesic

Boils, breakouts, cough, common cold, influenza, and
sinusitis. CAUTION: Not to be taken orally.

Chamomile

Sedative, antiinflammatory,
antiseptic, and pain reliever

Hay fever, burns, acne, arthritis, digestive problems,
and menstrual an menopausal symptoms.

Lavender

Analgesic, antiseptic,
calming/soothing

Headache, depression, insomnia, stress, sprains, and nausea.

Peppermint

Pain reliever

Indigestion, nausea, headache, motion sickness, and
muscle pain.

Rosemary

Antiseptic, stimulant, and diuretic

Indigestion, gas, bronchitis, fluid retention, and influenza.
CAUTION: Don't use if pregnant or have epilepsy or
hypertension.

Tarragon

Diuretic, laxative, antispasmodic,
and stimulant

Menstrual and menopausal symptoms, gas, and indigestion.
CAUTION: Don't use if pregnant.

Tea tree

Antiseptic and soothing

Common cold, bronchitis, abscesses, acne, vaginitis,
and burns.

Thyme

Stimulant, antiseptic, antibacterial,
and antispasmodic

Cough, laryngitis, diarrhea, gas, and intestinal worms.
CAUTION: Don't use if pregnant or have hypertension.

for wounded soldiers in World War II. He wrote about
his use of essential oils and their healing and antiseptic
properties, in his 1964 book Aromatherapie, traitement
des maladies par les essences des plantes, which popu-
larized the use of essential oils for medical and psychi-
atric treatment throughout France. Later, French bio-
chemist Mauguerite Maury popularized the cosmetic
benefits of essential oils, and in 1977 Robert Tisserand
wrote the first English language book on the subject. The
Art of Aromatherapy, which introduced massage as an
adjunct treatment to aromatherapy and sparked its popu-
larity in the United Kingdom.

Benefits

Aromatherapy offers diverse physical and psycho-
logical benefits, depending on the essential oil or oil
combination and method of application used. Some
common medicinal properties of essential oils used in
aromatherapy include: analgesic, antimicrobial, anti-
septic, anti-inflammatory, astringent, sedative, anti-
spasmodic, expectorant, diuretic, and sedative. Essen-
tial oils are used to treat a wide range of symptoms
and conditions, including, but not limited to, gastroin-
testinal discomfort, skin conditions, menstrual pain

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

and irregularities, stress-related conditions, mood dis-
orders, circulatory problems, respiratory infections,
and wounds.

Description

In aromatherapy, essential oils are carefully selected
for their medicinal properties. As essential oils are ab-
sorbed into the bloodstream through application to the
skin or inhalation, their active components trigger cer-
tain pharmalogical effects (e.g., pain relief).

In addition to physical benefits, aromatherapy has
strong psychological benefits. The volatility of an oil, or
the speed at which it evaporates in open air, is thought to
be linked to its specific psychological effect. As a rule of
thumb, oils that evaporate quickly are considered emo-
tionally uplifting, while slowly-evaporating oils are
thought to have a calming effect.

Essential oils commonly used in aromatherapy treat-
ment include:

• Roman chamomile ( Chamaemelum nobilis). An anti-
inflammatory and analgesic. Useful in treating otitis
media (earache), skin conditions, menstrual pains, and
depression.

123

Aromatherapy

Limbic system of the brain

As a holistic therapy, aromatherapy is believed to benefit both the mind and body. Here, the aromatic substances from a
flower stimulates the olfactory bulb and neurons. The desired emotional response (such as relaxation) is activated from the
limbic system of the brain. (Illustration by Electronic Illustrators Group. The Gale Group)

• Clary sage ( Salvia sclarea). This natural astringent is
not only used to treat oily hair and skin, but is also said
to be useful in regulating the menstrual cycle, improv-
ing mood, and controlling high blood pressure. Clary
sage should not be used by pregnant women.

• Lavender ( Lavandula officinalis). A popular aromather-
apy oil that mixes well with most essential oils, laven-
der has a wide range of medicinal and cosmetic appli-
cations, including treatment of insect bites, burns, res-
piratory infections, intestinal discomfort, nausea, mi-
graine, insomnia, depression, and stress.

• Myrtle ( Myrtus communis). Myrtle is a fungicide, dis-
infectant, and antibacterial. It is often used in steam
aromatherapy treatments to alleviate the symptoms of
whooping cough, bronchitis, and other respiratory in-
fections.

124

• Neroli (bitter orange), ( Citrus aurantium). Citrus oil
extracted from bitter orange flower and peel and used
to treat sore throat, insomnia, and stress and anxiety-
related conditions.

• Sweet orange ( Citrus sinensis). An essential oil used to
treat stomach complaints and known for its reported
ability to lift the mood while relieving stress.

• Peppermint ( Mentha piperita). Relaxes and soothes the
stomach muscles and gastrointestinal tract. Peppennint’s
actions as an anti-inflammatory, antiseptic, and antimi-
crobial also make it an effective skin treatment, and use-
ful in fighting cold and flu symptoms. In addition, re-
search in 2002 found that peppermint scent helped ath-
letes run faster and perform more push-ups than control
subjects with odorless strips under their noses.

• Rosemary ( Rosmarinus officinalis). Stimulating essential
oil used to treat muscular and rheumatic complaints, as

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

well as low blood pressure, gastrointestinal problems, and
headaches. Recently. Brain scans have shown that fra-
grance of rosemary increases blood circulation in the brain.

• Tea tree (Melaleuca alternifolia). Has bactericidal,
virucidal, fungicidal, and anti-inflammatory properties
that make it a good choice for fighting infection. Rec-
ommended for treating sore throat and respiratory in-
fections, vaginal and bladder infections, wounds, and a
variety of skin conditions.

• Ylang ylang ( Cananga odorata). A sedative essential oil
sometimes used to treat hypertension and tachycardia.

Essential oils contain active agents that can have po-
tent physical effects. While some basic aromatherapy
home treatments can be self-administered, medical aro-
matherapy should always be performed under the guid-
ance of an aromatherapist, herbalist, massage therapist,
nurse, or physician.

Inhalation

The most basic method of administering aromather-
apy is direct or indirect inhalation of essential oils. Sev-
eral drops of an essential oil can be applied to a tissue or
handkerchief and gently inhaled. A small amount of es-
sential oil can also be added to a bowl of hot water and
used as a steam treatment. This technique is recommend-
ed when aromatherapy is used to treat respiratory and/or
skin conditions. Aromatherapy steam devices are also
available commercially. A warm bath containing essen-
tial oils can have the same effect as steam aromatherapy,
with the added benefit of promoting relaxation. When
used in a bath, water should be lukewarm rather than hot
to slow the evaporation of the oil.

Essential oil diffusers, vaporizers, and light bulb
rings can be used to disperse essential oils over a large
area. These devices can be particularly effective in aro-
matherapy that uses essential oils to promote a healthier
home environment. For example, eucalyptus and tea tree
oil are known for their antiseptic qualities and are fre-
quently used to disinfect sickrooms, and citronella and
geranium can be useful in repelling insects.

Direct application

Because of their potency, essential oils are diluted in a
carrier oil or lotion before being applied to the skin to pre-
vent an allergic skin reaction. The carrier oil can be a veg-
etable or olive based one, such as wheat germ or avocado.
Light oils, such as safflower, sweet almond, grapeseed,
hazelnut, apricot seed, or peach kernel, may be absorbed
more easily by the skin. Standard dilutions of essential oils
in carrier oils range from 2-10%. However, some oils can
be used at higher concentrations, and others should be di-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

luted further for safe and effective use. The type of carrier
oil used and the therapeutic use of the application may also
influence how the essential oil is mixed. Individuals should
seek guidance from a healthcare professional and/or aro-
matherapist when diluting essential oils.

Massage is a common therapeutic technique used in
conjunction with aromatherapy to both relax the body and
thoroughly administer the essential oil treatment. Essen-
tial oils can also be used in hot or cold compresses and
soaks to treat muscle aches and pains (e.g., lavender and
ginger). As a sore throat remedy, antiseptic and soothing
essential oils (e.g., tea tree and sage) can be thoroughly
mixed with water and used as a gargle or mouthwash.

Internal use

Some essential oils can be administered internally in
tincture, infusion, or suppository form to treat certain
symptoms or conditions; however, this treatment should
never be self-administered. Essential oils should only be
taken internally under the supervision of a qualified
healthcare professional.

As non-prescription botanical preparations, the es-
sential oils used in aromatherapy are typically not paid
for by health insurance. The self-administered nature of
the therapy controls costs to some degree. Aromatherapy
treatment sessions from a professional aromatherapist
are not covered by health insurance in most cases, al-
though aromatherapy performed in conjunction with
physical therapy, nursing, therapeutic massage, or other
covered medical services may be covered. Individuals
should check with their insurance provider to find out
about their specific coverage.

The adage “You get what you pay for” usually ap-
plies when purchasing essential oils, as bargain oils are
often adulterated, diluted, or synthetic. Pure essential
oils can be expensive; and the cost of an oil will vary de-
pending on its quality and availability.

Preparations

The method of extracting an essential oil varies by
plant type. Common methods include water or steam dis-
tillation and cold pressing. Quality essential oils should be
unadulterated and extracted from pure botanicals. Many
aromatherapy oils on the market are synthetic and/or dilut-
ed, contain solvents, or are extracted from botanicals
grown with pesticides or herbicides. To ensure best re-
sults, essential oils should be made from pure organic
botanicals and labeled by their full botanical name. Oils
should always be stored in dark bottles out of direct light.

Before using essential oils on the skin, individuals
should perform a skin patch test by applying a small amount

125

Aromatherapy

of the diluted oil behind the wrist and covering it with a ban-
dage or cloth for up to 12 hours. If redness or irritation oc-
curs, the oil should be diluted further and a second skin test
performed, or it should be avoided altogether. Individuals
should never apply undiluted essential oils to the skin unless
advised to do so by a trained healthcare professional.

Precautions

Individuals should only take essential oils internally
under the guidance and close supervision of a health care
professional. Some oils, such as eucalyptus, wormwood,
and sage, should never be taken internally. Many essential
oils are highly toxic and should not be used at all in aro-
matherapy. These include (but are not limited to) bitter al-
mond, pennyroyal, mustard, sassafras, rue, and mugwort.

Citrus-based essential oils, including bitter and
sweet orange, lime, lemon, grapefruit, and tangerine, are
phototoxic, and exposure to direct sunlight should be
avoided for at least four hours after their application.

Other essential oils, such as cinnamon leaf, black
pepper, juniper, lemon, white camphor, eucalyptus blue
gum, ginger, peppermint, pine needle, and thyme can be
extremely irritating to the skin if applied in high enough
concentration or without a carrier oil or lotion. Caution
should always be exercised when applying essential oils
topically. Individuals should never apply undiluted es-
sential oils to the skin unless directed to do so by a
trained healthcare professional and/or aromatherapist.

Individuals taking homeopathic remedies should
avoid black pepper, camphor, eucalyptus, and pepper-
mint essential oils. These oils may act as a remedy anti-
dote to the homeopathic treatment.

Children should only receive aromatherapy treat-
ment under the guidance of a trained aromatherapist or
healthcare professional. Some essential oils may not be
appropriate for treating children, or may require addi-
tional dilution before use on children.

Certain essential oils should not be used by pregnant
or nursing women or by people with specific illnesses or
physical conditions. Individuals suffering from any chron-
ic or acute health condition should inform their healthcare
provider before starting treatment with any essential oil.

Asthmatic individuals should not use steam inhala-
tion for aromatherapy, as it can aggravate their condition.

Essential oils are flammable, and should be kept
away from heat sources.

Side effects

Side effects vary by the type of essential oil used.
Citrus-based essential oils can cause heightened sensitiv-
ity to sunlight. Essential oils may also cause contact

126

dermatitis, an allergic reaction characterized by redness
and irritation. Anyone experiencing an allergic reaction
to an essential oil should discontinue its use and contact
their healthcare professional for further guidance. Indi-
viduals should do a small skin patch test with new essen-
tial oils before using them extensively.

Research & general acceptance

The antiseptic and bactericidal qualities of some es-
sential oils (such as tea tree and peppermint) and their
value in fighting infection has been detailed extensively
in both ancient and modern medical literature.

Recent research in mainstream medical literature
has also shown that aromatherapy has a positive psycho-
logical impact on patients. Several clinical studies in-
volving both post-operative and chronically ill subjects
showed that massage with essential oils can be helpful in
improving emotional well-being, and consequently, pro-
moting the healing process.

Today, the use of holistic aromatherapy is widely ac-
cepted in Europe, particularly in Great Britain, where it
is commonly used in conjunction with massage as both a
psychological and physiological healing tool. In the
United States, where aromatherapy is often misunder-
stood as solely a cosmetic treatment, the mainstream
medical community has been slower to accept its use.

Training & certification

Certification or licensing is currently not required to
become an aromatherapist in the United States; however,
many states require that healthcare professionals who
practice the “hands-on” therapies often used in conjunc-
tion with aromatherapy (e.g., massage) to be licensed.
There are state-licensed educational institutions that
offer certificates and/or diplomas in aromatherapy train-
ing. Individuals interested in aromatherapy treatment
from a professional aromatherapist may be able to obtain
a referral from one of these institutions, or from their
current healthcare provider.

Resources

BOOKS

Lawless, Julia. The Complete Illustrated Guide To Aromathera-
py. Rockport, MA: Element Books Ltd, 1997.

Schnaubelt, Kurt. Medical Aromatherapy: Healing With Essen-
tial Oils. Berkeley, CA: Frog Ltd, 1999.

PERIODICALS

ORGANIZATIONS

Claps, Frank.“Training Scents: You May be Able to Sniff Your
Way to Better Workouts with Tricks from the Aromathera-
pist's Bag.” Men's Fitness (May 2002):34.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Antiseptic — Inhibits the growth of microorgan-
isms.

Bactericidal — An agent that destroys bacteria
(e.g., Staphylococci aureus, Streptococci pneumo-
niae, Escherichia coli, Salmonella enteritidis).
Carrier oil — An oil used to dilute essential oils for
use in massage and other skin care applications.

Contact dermatitis — Skin irritation as a result of
contact with a foreign substance.

Essential oil — A volatile oil extracted from the
leaves, fruit, flowers, roots, or other components
of a plant and used in aromatherapy, perfumes,
and foods and beverages.

Holistic — A practice of medicine that focuses on
the whole patient, and addresses the social, emo-
tional, and spiritual needs of a patient as well as
their physical treatment.

Phototoxic — Causes a harmful skin reaction when
exposed to sunlight.

Remedy antidote — Certain foods, beverages, pre-
scription medications, aromatic compounds, and
other environmental elements that counteract the
efficacy of homeopathic remedies.

Steam distillation — A process of extracting essen-
tial oils from plant products through a heating and
evaporation process.

Volatile — Something that vaporizes or evaporates
quickly when exposed to air.

Stanten, Michele, and Selene Yeager.“Smell this for Instant En-
ergy: the Easiest Way to Boost your Workouts. (Fitness
News).” Prevention (April 2002):76.

National Association of Holistic Aromatherapy. 836 Hanley In-
dustrial Court, St. Louis, MO 63144. 888-ASK-NAHA.
<http://www.naha.org.>

Paula Ford-Martin
Teresa G. Odle

Arrowroot

Description

Growing to a height of up to 6 ft (2 m), arrowroot is
a tropical perennial with clusters of long, thin stems and

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

small, cream-colored flowers that grow in pairs. Once
revered by the ancient Mayans and other inhabitants of
Central America as an antidote for poison-tipped arrows,
the herb is mainly used today to soothe the stomach and
alleviate diarrhea. It has also been popular for centuries
in the culinary arts and is still used in many American
kitchens as a thickening agent. While arrowroot is native
to Central America and widely cultivated in the West In-
dies, it can also be found growing in many tropical re-
gions of the world, including Southeast Asia, South
Africa, Australia, and in Florida in the United States.
The Latin genus Maranta was derived from the name of
an Italian doctor, Bartommeo Maranto.

Arrowroot, which belongs to the Marantaceae plant
family, is widely considered an easily digested and nutri-
tious starch. The herb is extracted from the fleshy roots,
called rhizomes, of the arrowroot plant through an elabo-
rate process of washing, peeling, soaking, and drying in
the sun. The end product is a fine, white powder with the
same appearance and texture as cornstarch. Arrowroot is
valued by herbalists primarily for its demulcent and an-
tidiarrheal properties. Exactly how it produces its thera-
peutic effects is not known. The chemical composition of
the herb has not been thoroughly investigated.

While only Maranta arundinacea is considered true
arrowroot, the common name for the herb is often ap-
plied to a variety of starches. These include other species
of Maranta , such as Maranta ramosissima, Maranta al-
louya, Maranta nobilis, as well as Brazilian arrowroot
(Manihot utilissima or Manihot palmate), Tahitian ar-
rowroot ( Tacca oceanica), and East Indian arrowroot
( Curcuma augustifolia ). While some of these starches
may be chemically similar to true arrowroot, it is not
clear if they produce the same medicinal effects. Con-
sumers interested in trying arrowroot are advised to
choose Maranta arundinacea , which is sometimes re-
ferred to as West Indian arrowroot or simply Maranta.

As of 2000, much research is still required to deter-
mine if arrowroot can produce significant health benefits
safely and effectively. The proper dosage of the herb has
also yet to be determined.

General use

While not approved by the United States Food and
Drug Administration (FDA), arrowroot is thought to
have several beneficial effects. However, there is little
scientific evidence to support these claims. Today, the
herb is primarily used to soothe an uneasy stomach and
alleviate diarrhea or nausea and vomiting. Since it con-
tains calcium and carbohydrates as well as other nutri-
ents, arrowroot is also used as an easily digested source
of nutrition for infants, people recovering from illnesses

127

Arrowroot

Arsenicum album

(especially those with bowel problems), and those on re-
stricted diets . The herb is considered easier on the stom-
ach than other forms of starch.

Because arrowroot has not been studied extensively in
people or animals, its effectiveness is based mainly on its
reputation as a folk remedy. Despite the lack of scientific ev-
idence, some practitioners of alternative medicine consider it
useful for certain conditions. Alternative physicians praise
the stomach-soothing powers of arrowroot as well as its nu-
tritional value. Another prominent herbalist recommends ar-
rowroot for preventing athlete’s foot. Putting the dried pow-
der inside socks and shoes can help to combat the moisture
that contributes to the growth of foot fungus. However, ar-
rowroot is not known to have antifungal properties.

Arrowroot was popular in the past as an antidote for
arrow poison. It also had a reputation as a treatment for
scorpion and spider bites as well as gangrene. However,
there is no scientific evidence to support these uses. In
cases of poisoning, the local poison control center or an
emergency care center should be contacted immediately.

Aside from its medicinal uses, arrowroot is still used
in cooking. Much like cornstarch, arrowroot is used as a
thickener for sauces, soups, and confections.

Preparations

The optimum daily dosage of arrowroot has not
been established with any certainty. Consumers should
follow the package directions for proper use or consult a
doctor experienced in the use of alternative remedies.
Arrowroot powder, which is basically flavorless, is often
mixed with juice or other beverages before ingestion.

Precautions

Arrowroot is not known to be harmful when taken in
recommended dosages. However, it is important to re-
member that the long-term effects of taking the herb ( in
any amount) have not been investigated. Due to the lack
of sufficient medical research, arrowroot should be used
with caution in children, women who are pregnant or
breast-feeding, and people with liver or kidney disease.

People who experience vomiting or severe/pro-
longed diarrhea may be prone to dehydration. They
should drink plenty of water (six to eight glasses a day)
in order to maintain a proper fluid balance. A doctor
should be consulted if the vomiting or diarrhea lasts
longer than three days or is accompanied by other symp-
toms such as pain or fever.

Side effects

When taken in recommended dosages, arrowroot is
not associated with any significant side effects.

128

KEY TERMS

Calcium — A mineral necessary for strong bones
and the proper functioning of organs and muscles.

Demulcent — A gelatinous or oily substance that
has a protective or soothing influence on irritated
mucous membranes.

Gangrene — Localized tissue death caused by lack
of blood.

Rhizome — A relatively long and thick plant root
that can be distinguished from normal roots by the
presence of buds, nodes, or other characteristics.

Interactions

Arrowroot is not known to interact adversely with
any drug or dietary supplement. It has been combined
with milk, lemon and other fruit juices, sugar, and wine
without apparent harm.

To avoid constipation, consumers should not take
aiTowroot with other medications or dietary supplements
used to alleviate diarrhea.

Resources

BOOKS

Gruenwald, Joerg. PDR for Herbal Medicines. New Jersey:
Medical Economics, 1998.

PERIODICALS

Rolston D. D., P. Mathew, and V. I. Mathan. “Food-Based So-
lutions Are a Viable Alternative to Glucose-Electrolyte
Solutions for Oral Hydration in Acute Diarrhoea-Studies
in a Rat Model of Secretory Diarrhoea.” Transactions of
the Royal Society of Tropical Medicine and Hygiene 84,
no. 1 (1990): 156-159.

ORGANIZATIONS

American Botanical Council. P.O. Box 144345, Austin, TX
78714-4345.

OTHER

Botanical.com. <http://www.botanical.com>.

Greg Annussek

Arsenicum album

Description

Arsenicum album is a homeopathic remedy derived
from the metallic element arsenic. Traces of arsenic are

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

found in vegetables and animals. In its crude form, arsenic
is poisonous. Gradual accumulations may result in diges-
tive disturbances, nausea, vomiting, diarrhea, dehydra-
tion, coma, shock, convulsions, paralysis, and death.

Common names for arsenicum album include ar-
senic trioxide, white arsenic, white oxide of metallic ar-
senic, and arsenius acid. Arsenic is indestructible, even
by fire, and remains in bone ash after cremation. It has
been used to create pigmentation for wallpaper, carpet,
and paints. Arsenic has also been used to produce medi-
cines and pesticides.

Arsenic was used as a remedy for certain types of
cattle disease as far back as the eighth century. In the
seventeenth century, arsenic was applied topically to
treat malignant ulcers and skin diseases in humans.
Taken internally, it was used to treat fevers. When fre-
quent and repeated doses of arsenic resulted in poisoning
and death, arsenic was pronounced unsafe for use. How-
ever, housewives and practitioners still used arsenic and
were often successful in their treatments. Eventually ar-
senic use was reinstated. Weak compounds of arsenic
were often used to increase strength and endurance, rem-
edy anemia, and improve the skin and fur of animals. An
ointment made from arsenic was used to treat cancerous
growths and tumors.

General use

Arsenicum album is one of the most frequently used
homeopathic remedies and is one of the most well-
proven remedies. A polychrest with a wide field of ac-
tion, arsenicum album has the power to affect all parts of
the human body.

Arsenicum album is used to treat serious acute ail-
ments, chronic diseases, and acute colds, bronchitis, and
fevers. Homeopaths prescribe this remedy to treat asthma,
anxiety disorders, panic attacks, skin infections, boils,
burns with blisters, cystitis, eye inflammations, chicken-
pox, colds, coughs, indigestion, Crohn’s disease, herpes
simplex, flu, insomnia, measles, mumps, sore throats, al-
lergies and hay fever, food poisoning, and fevers. Ar-
senicum album has also been used to treat malarial and
septic infections, alcoholism, syphilis, lupus, and cancer
(when applied in the early stages of the disease).

Arsenicum album illnesses can be brought about by
the use of quinine, tobacco, or alcohol, or from the sup-
pression of skin eruptions, sweat, or mucous membrane
discharges.

Common characteristics

People requiring arsenicum album generally fit a
particular profile. They are anxious, restless, weak, pale,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

emaciated, faint, chilled, and catch colds easily. Their
eyes are sunken and glassy; their faces is yellowish or
ashy pale, and mouth, lips, and tongue are parched and
dry. They desire liquids in small, frequent amounts. The
forehead, face, chest, knees, hands, and feet are often
cold, so patients crave warmth. They may suffer from
burning, pressing pains throughout the entire body.
These pains are aggravated by cold and reduced by heat.
Weakness is sudden and is reduced by lying down, al-
though the other symptoms are worsened by it.

Other physical characteristics of this remedy include
burning, offensive, and watery discharges; palpitations;
profuse, sour sweat; and a red-tipped tongue. There is a
tendency to bleed easily and from any place, and vomit-
ing of blood and bleeding from lungs, throat, and mu-
cous membranes are not uncommon.

The mental and emotional symptoms of the patient
profile also include anxiety, nervousness, suspicion, im-
pulsiveness, irritability, sadness, hopelessness, and de-
pression. People requiring this remedy are often difficult
patients. They are critical and argumentative, easily of-
fended, easily startled, insecure, forgetful, sensitive to
pain, and often suffer from delusions or hallucinations.
They think their ailment is more serious than it is and de-
spair of ever getting well, often fearing that they are
going to die. They desire company and are afraid of
being alone. Patients may be unable to sleep due to their
restlessness and anxiety or from physical discomforts
such as fever or cough. When they do sleep, they may
have anxious dreams or nightmares. Even though they
are extremely weak, arsenicum album patients are clean
and tidy, partially to relieve their restlessness.

The symptoms are aggravated by a change in tem-
perature, wet weather, cold food and drink, and by the
slightest exertion. They are worse after midnight, upon
waking, with alcohol use, and during menstruation.
Symptoms are improved by heat, hot beverages, the
warmth of the bed, fresh air, and lying down.

Arsenicum album is a useful remedy for mental dis-
orders with symptoms of melancholy, irritation, intense
anxiety, and restlessness. The patient may be prone to vi-
olent fits of anger or rage or have an impulse to commit
murder. It also can have a positive effect on alcoholism
and can improve diarrhea, weakness, stomach irritation,
and emaciation.

Specific indications

Arsenicum album can be used for the following con-
ditions:

• Throbbing, frontal headaches. These are accompanied
by a flushed or hot face, heat or burning inside the
head, and a feeling that the head will explode. These

129

Arsenicum album

Art therapy

headaches occur with regularity and are reduced by
cool air or cold applications.

• Herpetic or eczematous skin eruptions. These are
moist, scabby, pustular, itching, or burning.

• Hot, burning fevers. These sometimes alternate with
chills. Fevers are worse at night, particularly after mid-
night.

• Sore throat. It is accompanied by burning pain that is
worse from swallowing or cold drinks and is reduced
with hot drinks.

• Hacking coughs. These are frequently dry at night and
are relieved by hot drinks. They are worsened by the
cold, by fresh air, when lying down, at night (particu-
larly after midnight), and during a fever.

• Chronic nasal congestion. This is often accompanied
by bleeding, constant sneezing, chills, fatigue, restless-
ness, anxiety at night, troublesome dreams, and crusts
in the back of the nose.

Preparations

The homeopathic remedy is prepared by separating
arsenic from iron, cobalt, and nickel when the minerals
are baked at high temperatures. The powder is then
ground and diluted with milk sugar.

Arsenicum album is available at health food and
drug stores in various potencies in the form of tinctures,
tablets, and pellets.

Precautions

If symptoms do not improve after the recommended
time period, a homeopath or healthcare practitioner
should be consulted.

Consumers are advised not to exceed the recom-
mended dose.

Side effects

There are no side effects currently reported.

Interactions

When taking any homeopathic remedy, consumers
should not use peppermint products, coffee, or alcohol.
These products may cause the remedy to be ineffective.

Resources

BOOKS

Cummings, Stephen, M.D., and Ullman, Dana, M.P.H. Every-
body’s Guide to Homeopathic Medicines. New York: Jere-
my P. Tarcher/Putnam, 1997.

130

KEY TERMS

Polychrest — A homeopathic remedy that is used
to treat many ailments.

Pustular — Resembling a blister and usually con-
taining pus.

Kent, James Tyler. Lectures on Materia Medica. Delhi. India:
B. Jain Publishers, 1996.

Jennifer Wurges

Arthritis see Osteoarthritis; Rheumatoid
arthritis

Art therapy

Definition

Art therapy, sometimes called creative arts therapy
or expressive arts therapy, encourages people to express
and understand emotions through artistic expression and
through the creative process.

Origins

Humans have expressed themselves with symbols
throughout history. Masks, ritual pottery, costumes, other
objects used in rituals, cave drawings, Egyptian hiero-
glyphics, and Celtic art and symbols are all visual
records of self-expression and communication through
art. Art has also been associated spiritual power, and
such artistic forms as the Hindu and Buddhist mandala
and Native American sand painting are considered pow-
erful healing tools.

In the late nineteenth century, French psychiatrists
Ambrose Tardieu and Paul-Max Simon both published
studies on the similar characteristics of and symbolism
in the artwork of the mentally ill. Tardieu and Simon
viewed art therapy as an effective diagnostic tool to iden-
tify specific types of mental illness or traumatic events.
Later, psychologists would use this diagnostic aspect to
develop psychological drawing tests (the Draw-A-Man
test, the Draw-A-Person Questionnaire [DAP.Q]) and
projective personality tests involving visual symbol
recognition (e.g., the Rorschach Inkblot Test, the The-
matic Apperception Test [TAT], and the Holtzman
Inkblot Test [HIT]).

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

The growing popularity of milieu therapies at psy-
chiatric institutions in the twentieth century was an im-
portant factor in the development of art therapy in the
United States. Milieu therapies (or environmental ther-
apy) focus on putting the patient in a controlled thera-
peutic social setting that provides the patient with oppor-
tunities to gain self-confidence and interact with peers in
a positive way. Activities that encourage self-discovery
and empowerment such as art, music, dance, and writing
are important components of this approach.

Educator and therapist Margaret Naumburg was a
follower of both Freud and Jung, and incorporated art
into psychotherapy as a means for her patients to visual-
ize and recognize the unconscious. She founded the
Walden School in 1915, where she used students’ art-
works in psychological counseling. She published exten-
sively on the subject and taught seminars on the tech-
nique at New York University in the 1950s. Today, she is
considered the founder of art therapy in the United States.

In the 1930s, Karl, William, and Charles Menninger
introduced an art therapy program at their Kansas-based
psychiatric hospital, the Menninger Clinic. The Men-
ninger Clinic employed a number of artists in residence
in the following years, and the facility was also consid-
ered a leader in the art therapy movement through the
1950s and 60s. Other noted art therapy pioneers who
emerged in the 50s and 60s include Edith Kramer, Hanna
Yaxa Kwiatkowska (National Institute of Mental
Health), and Janie Rhyne.

Benefits

Art therapy provides the client-artist with critical in-
sight into emotions, thoughts, and feelings. Key benefits
of the art therapy process include:

• Self-discovery. At its most successful, art therapy trig-
gers an emotional catharsis.

• Personal fulfillment. The creation of a tangible reward
can build confidence and nurture feelings of self-worth.
Personal fulfillment comes from both the creative and
the analytical components of the artistic process.

• Empowerment. Art therapy can help people visually
express emotions and fears that they cannot express
through conventional means, and can give them some
sense of control over these feelings.

• Relaxation and stress relief. Chronic stress can be
harmful to both mind and body. Stress can weaken and
damage the immune system, can cause insomnia and
depression, and can trigger circulatory problems (like
high blood pressure and irregular heartbeats). When
used alone or in combination with other relaxation

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Art therapist with students. (Peter Berndt. Custom Medical
Stock Photo, Inc. Reproduced by permission.)

techniques such as guided imagery, art therapy can ef-
fectively relieve stress.

• Symptom relief and physical rehabilitation. Art therapy
can also help patients cope with pain. This therapy can
promote physiological healing when patients identify and
work through anger, resentment, and other emotional
stressors. It is often prescribed to accompany pain control
therapy for chronically and terminally ill patients.

Description

Art therapy, sometimes called expressive art or art
psychology, encourages self-discovery and emotional
growth. It is a two part process, involving both the cre-
ation of art and the discovery of its meaning. Rooted in
Freud and Jung’s theories of the subconscious and un-
conscious, art therapy is based on the assumption that vi-
sual symbols and images are the most accessible and nat-
ural form of communication to the human experience.
Patients are encouraged to visualize, and then create, the
thoughts and emotions that they cannot talk about. The
resulting artwork is then reviewed and its meaning inter-
preted by the patient.

The “analysis” of the artwork produced in art thera-
py typically allows patients to gain some level of insight

131

Art therapy

into their feelings and lets them to work through these is-
sues in a constructive manner. Art therapy is typically
practiced in conjunction with individual, group, or fami-
ly psychotherapy (talk therapy). While a therapist may
provide critical guidance for these activities, a key fea-
ture of effective art therapy is that the patient/artist, not
the therapist, directs the interpretation of the artwork.

Art therapy can be a particularly useful treatment
tool for children, who frequently have limited language
skills. By drawing or using other visual means to express
troublesome feelings, younger patients can begin to ad-
dress these issues, even if they cannot identify or label
these emotions with words. Art therapy is also valuable
for adolescents and adults who are unable or unwilling to
talk about thoughts and feelings.

Beyond its use in mental health treatment, art thera-
py is also used with traditional medicine to treat organic
diseases and conditions. The connection between mental
and physical health is well documented, and art therapy
can promote healing by relieving stress and allowing the
patient to develop coping skills.

Art therapy has traditionally centered on visual
mediums, like paintings, sculptures, and drawings. Some
mental healthcare providers have now broadened the def-
inition to include music, film, dance, writing, and other
types of artistic expression.

Art therapy is often one part of a psychiatric inpatient
or outpatient treatment program, and it can take place in
individual or group therapy sessions. Group art therapy
sessions often take place in hospital, clinic, shelter, and
community program settings. These group therapy ses-
sions can have the added benefits of positive social inter-
action, empathy, and support from peers. The client-artist
can learn that others have similar concerns and issues.

Preparations

Before starting art therapy, the therapist may have an
introductory session with the client-artist to discuss art
therapy techniques and give the client the opportunity to
ask questions about the process. The client-artist’s comfort
with the artistic process is critical to successful art therapy.

The therapist ensures that appropriate materials and
space are available for the client-artist, as well as an ade-
quate amount of time for the session. If the individual
artist is exploring art as therapy without the guidance of a
trained therapist, adequate materials, space, and time are
still important factors in a successful creative experience.

The supplies used in art therapy are limited only by the
artist’s (and/or therapist’s) imagination. Some of the materi-
als often used include paper, canvas, poster board, assorted
paints, inks, markers, pencils, charcoals, chalks, fabrics,

132

string, adhesives, clay, wood, glazes, wire, bendable metals,
and natural items (like shells, leaves, etc.). Providing artists
with a variety of materials in assorted colors and textures
can enhance their interest in the process and may result in a
richer, more diverse exploration of their emotions in the re-
sulting artwork. Such appropriate tools as scissors, brushes,
erasers, easels, supply trays, glue guns, smocks or aprons,
and cleaning materials are also essential.

An appropriate workspace should be available for the
creation of art. Ideally, this should be a bright, quiet, com-
fortable place, with large tables, counters, or other suitable
surfaces. The space can be as simple as a kitchen or office
table, or as fancy as a specialized artist’s studio.

The artist should have adequate time to become
comfortable with and explore the creative process. This
is especially true for people who do not consider them-
selves “artists” and may be uncomfortable with the con-
cept. If performed in a therapy group or one-on-one ses-
sion, the art therapist should be available to answer gen-
eral questions about materials and/or the creative
process. However, the therapist should be careful not to
influence the creation or interpretation of the work.

Precautions

Art materials and techniques should match the age
and ability of the client. People with impairments, such
as traumatic brain injury or an organic neurological con-
dition, may have difficulties with the self-discovery por-
tion of the art therapy process depending on their level of
functioning. However, they may still benefit from art
therapy through the sensory stimulation it provides and
the pleasure they get from artistic creation.

While art is accessible to all (with or without a ther-
apist to guide the process), it may be difficult to tap the
full potential of the interpretive part of art therapy with-
out a therapist to guide the process. When art therapy is
chosen as a therapeutic tool to cope with a physical con-
dition, it should be treated as a supplemental therapy and
not as a substitute for conventional medical treatments.

Research & general acceptance

A wide body of literature supports the use of art
therapy in a mental health capacity. And as the mind-
body connection between psychological well-being and
physical health is further documented by studies in the
field, art therapy gains greater acceptance by mainstream
medicine as a therapeutic technique for organic illness.

Training & certification

Both undergraduate and graduate art therapy pro-
grams are offered at many accredited universities across

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Catharsis — Therapeutic discharge of emotional
tension by recalling past events.

Mandala — A design, usually circular, that appears
in religion and art. In Buddhism and Hinduism,
the mandala has religious ritual purposes and
serves as a yantra (a geometric emblem or instru-
ment of contemplation).

Organic illness — A physically, biologically based
illness.

the United States. Typical art therapy programs combine
courses in art and psychology. The majority of these pro-
grams meets or exceeds standards set by the American
Art Therapy Association (AATA).

The Art Therapy Credentials Board (ATCB), a volun-
tary organization, grants the designation ATR (Art Thera-
pist Registered) to professionals who have completed an
approved master’s level program of study in art therapy
(as described by the AATA) and have accumulated at least
1,000 hours of additional supervised clinical experience.
Board certification is also available through the ATCB for
art therapists who have met the ATR requirements and
have passed a certification exam (ATR-BC). Art therapists
with the ATR-BC designation must complete continuing
education credits to maintain their certification.

Registration and/or certification is a recognition of
professional expertise, not a legal qualification or re-
quirement to practice. Professional licensing require-
ments for art therapists vary by state. However, if the
therapy is intended as a companion treatment to psycho-
logical counseling or other mental health treatment, state
licensing requirements typically apply. Where licensing
is a prerequisite to practice, a combination of education
and clinical experience, a written test, and continuing ed-
ucation are required to maintain the license.

Resources

BOOKS

Fausek, Diane. A Practical Guide to Art Therapy. Binghamton.

New York: Haworth Press, 1997.

Ganim, Barbara. Art and Healing: Using expressive art to heal
your body, mind, and spirit. New York: Three Rivers
Press, 1999.

Malchiodi, Cathy A. The Art Therapy Sourcebook. Los Ange-
les: Lowell House, 1998.

McNiff, Shaun. Art as Medicine: Creating a Therapy of the
Imagination. Boston: Shambhala, 1992.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ORGANIZATIONS

American Art Therapy Association. 1202 Allanson Rd.,
Mundelein, IL 60060-3808. 888-290-0878 or 847-949-
6064. Fax: 847-566-4580. E-mail: arttherapy@ntr.net
w w w.arttherapy . org .

Paula Ford-Martin

Ascorbic acid see Vitamin C

Ashwaganda

Description

Ashwaganda, also spelled ashwagandha, is a member
of the pepper family known as Withania somnifera. The
small evergreen grows in the frost-free drier parts of west-
ern India, northern Africa, the Mediterranean, and the
Middle East. Ashwaganda grows to a height of 2-3 ft
(about 1 m) and has oval leaves, showy yellow flowers,
and red, raisin-sized fruits. All parts of the plant, including
the root, are used medicinally. Ashwaganda is also called
winter cherry, withania, asgandh, and Indian ginseng.

General use

Ashwaganda is a major herb in the Ayurvedic sys-
tem of health and healing. Ayurvedic medicine is a sys-
tem of individualized healing derived from Hinduism
that has been practiced in India for more than 2,000
years. It is a complex system that recognizes different
human temperaments and body types. Each of these
types has different qualities that affect a person’s health
and natural balance.

In Ayurvedic medicine, disease can result from any
of seven major categories of factors: heredity, congenital,
internal, external trauma, seasonal, habits, or supernatur-
al factors. Disease can also be caused by misuse of the
five senses: sight, touch, taste, hearing, and smell. Diag-
noses are made through questioning, observation, exami-
nation, and interpretation. Health is restored by evaluat-
ing the exact cause of the imbalance causing the disease
or condition and then prescribing herbs, exercises, diet
changes and/or meditation to help restore the natural
balance of body, mind, and spirit. Prescriptions are high-
ly individualized, so that the same symptoms may re-
quire different remedies in different people.

Ashwaganda is used to treat a great many different
conditions in Ayurvedic medicine. Every part of the plant
is used: leaves, fruit, flowers, and root. In addition, the

133

Ashwaganda

Ashwaganda plant. (© PlantaPhile, Germany. Reproduced by
permission.)

young shoots and seeds are used as food and to thicken
plant milks in the making of vegan cheeses. The fruit can
be used as a substitute for soap, and the leaves are some-
times used as an insect repellent. Although ashwaganda
can be taken alone, it is more often combined with other
herbs in tonics to enhance its rejuvenating effects.

Indian ginseng

Ashwaganda is sometimes called the Indian ginseng
because its actions and uses are in many ways similar to
those of Chinese ginseng, although its cost is much
lower. In Hindi, the name of ashwaganda means “horse
smell.” This name refers less to the herb’s odor than to a
horse’s strength and health. Ashwaganda is supposed to
impart that same horse-like strength to the people who
use it.

Ashwaganda is an adaptogen. Adaptogens are sub-
stances that non-specifically enhance and regulate the
body’s ability to withstand stress and increase its general
performance in ways that help the whole body resist dis-
ease. Ashwaganda is celebrated as an adaptogen that will
do all of the following:

• boost strength

• increase stamina and relieve fatigue

• enhance sexual energy and rejuvenate the body

• strengthen the immune system

• speed recovery from chronic illness

• strengthen sickly children

• soothe and calm without producing drowsiness

• clarify the mind and improve memory

• slow the aging process

The powdered root of ashwaganda is normally used
for whole body tonics that improve general health and well
being. For most of these uses, ashwaganda is prepared as
part of a rasayana , or rejuvenating formula that contains
many different herbs. The use of ashwaganda in multi-herb
formulas makes it difficult for modern laboratory scientists
to assess its specific effects as an adaptogen.

Disease-specific uses

In addition to the whole body effects of ashwagan-
da, the plant is used for many other specific conditions.
Different parts are used for different conditions. Ashwa-
ganda is one of the most frequently used remedies in
India. It is taken internally for:

• anemia

• arthritis

• asthma

134

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• bronchitis

• cancer

• chronic fatigue syndrome

• colds

• coughs

• depression

• diarrhea

• fluid retention

• hemorrhoids

• hypertension

• hypoglycemia

• leprosy

• nausea

• rheumatism

• sexually transmitted diseases

• stomach ulcers

• systemic lupus erythematosus

• tuberculosis

• tumors

Ashwaganda can also be made into a poultice for
external use, as it is thought to have antibacterial and an-
tifungal properties. It is used to prevent infection in skin
wounds and to treat skin diseases, including psoriasis,
ringworm, and scabies.

Laboratory studies

University and medical researchers have been study-
ing ashwaganda since at least the early 1960s. Chemical
analysis shows that ashwaganda contains compounds
thought to have anti-tumor, anti-inflammatory, and anti-
fungal properties. Other compounds have been isolated
that are associated with ashwaganda’s sedative and anti-
stress effects.

The most rigorous laboratory tests have been done
in test tubes and on rats, mice, and other small laboratory
animals. There is no proof that ashwaganda affects hu-
mans in the same way that it affects rodents. In animal
studies, however, ashwaganda has been shown to have
consistent anti-inflammatory, anti-fungal, anti-stress, and
sedative effects. In one well-known study, extracts of
ashwaganda root were shown to significantly increase
the swimming endurance of rats in a test that is consid-
ered a classic stress test.

Experimenters have had mixed results in demon-
strating anti-tumor and anti-cancer properties of ashwa-
ganda. Many have found that extracts of ashwaganda

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

root slow the growth of tumor cells in test-tube and
small-animal experiments, but these results have not yet
been reproduced in human subjects. Some researchers
report that ashwaganda makes tumors more sensitive to
chemotherapy and radiation therapy without increasing
side effects caused by these therapies.

Although there is little doubt that ashwaganda con-
tains biologically active compounds that produce some
of the healing effects in humans that have been found in
test-tube and small-animal studies, few controlled stud-
ies using people have been done. One drawback to arriv-
ing at conclusive evidence in humans is that most people
take ashwaganda as part of a multi-herb tonic, making it
difficult for researchers to attribute specific actions to
any one particular component of the formula. Scientific
interest in ashwaganda is high, and laboratory studies
continue to be performed.

Preparations

Ashwaganda is available in many forms, including
powders, decoctions, essential oil, tinctures, and teas
made from the root, root bark, and the leaves. Commer-
cially ashwaganda is available as capsules. The usual cap-
sule dosage is 300 mg of powdered root, taken once or
twice a day. Tincture dosage is often 2-4 ml (0.5-1 tsp)
daily. Ashwaganda tea can be made by boiling the roots
for about 15 minutes. Three cups a day is recommended.
The fruit is often chewed to assist in convalescence from
prolonged illness. These are simply representative doses
and uses, since Ayurvedic medicine is highly individual-
ized. The dose recommended depends on both the body
type of the person and the nature of his or her illness.

Precautions

Ashwaganda is not recommended for use by pregnant
women. Thousands of years of use have shown that this
plant is quite safe. On the other hand, laboratory tests indi-
cate that rats given high levels of ashwaganda root extract
develop kidney lesions. This effect has not been seen in
humans, but using the herb in moderation may be prudent.

Ashwaganda has a sedative effect on the central ner-
vous system. It will enhance the effect of any other cen-
tral nervous system sedatives (e.g., barbiturates or alco-
hol) that are taken at the same time. People operating
heavy equipment or working in situations that require a
high level of alertness should keep this in mind when
using ashwaganda.

Side effects

No undesirable side effects have been reported with
ashwaganda.

135

Ashwaganda

Asthma

KEY TERMS

Adaptogen — A substance that acts in nonspecific
ways to improve the body's level of functioning
and its adaptations to stress.

Decoction — A liquid extract of a herb, made by
simmering or boiling the herb in water, then
straining out the plant parts.

Poultice — A soft moist mass of cloth, usually con-
taining herbs, applied warm or hot to relieve pain
or speed healing in a part of the body.

Psoriasis — A skin disease characterized by dry,
scaling, whitish patches.

Scabies — A contagious skin disease caused by a
mite and characterized by small, raised, red, very
itchy pinprick bumps on the skin.

Tincture — An alcohol-based extract of a herb pre-
pared by soaking plant parts in alcohol or a mix-
ture of alcohol and water.

Tonic — A medicine given to strengthen and invig-
orate the body. Ashwaganda is frequently used as
a tonic.

Vegan — Food products made without any animal
products such as meat, milk, or eggs. A vegan diet
is a nutrition regimen that excludes all animal
products.

Interactions

There are few, studies of how ashwaganda interacts
with traditional Western medicines. It has been used for
many years in combination with other Ayurvedic herbs
without incident. Ayurvedic practitioners believe that
when ashwaganda is combined with other herbs in reju-
venation formulas, it enhances the effects of these other
herbs.

Resources

BOOKS

Chevallier, Andrew. Encyclopedia of Medicinal Plants. Lon-
don: Dorling Kindersley, 1996.

Peirce, Andrea. The American Pharmaceutical Association
Practical Guide to Natural Medicines. New York: William
Morrow and Company, 1999.

ORGANIZATIONS

American School of Ayurvedic Sciences. 2115 112th Avenue
NE. Bellevue, WA 98004. (425) 453-8002.

The Ayurvedic Institute. P. O. Box 23445. Albuquerque, NM
87112. (505) 291-9698.

136

OTHER

“Withania somnifera aphrodisiaca Plants for the Future:
<http:// www.metalab.unc.edu.>

Tish Davidson

Asthma

Definition

Asthma is a chronic inflammatory disease of the air-
ways in the lungs. This inflammation periodically causes
the airways to narrow, producing wheezing and breath-
lessness sometimes to the point where the patient gasps
for air. This obstruction of the air flow either stops spon-
taneously or responds to a wide range of treatments.
Continuing inflammation makes asthmatics hyper-re-
sponsive to such stimuli as cold air, exercise, dust, pollu-
tants in the air, and even stress or anxiety.

Description

Between 16 and 17 million Americans have asthma
and the number has been rising since 1980. As many as 9
million U.S. children under age 18 may have asthma.
Blacks, Hispanics, American Indians, and Alaskan na-
tives had higher rates of asthma-control problems than
whites or Asians in the United States.

The changes that take place in the lungs of asthmat-
ics make their airways (the bronchi and the smaller bron-
chioles) hyper-reactive to many different types of stimuli
that do not affect healthy lungs. In an asthma attack, the
muscle tissue in the walls of the bronchi go into spasm,
and the cells that line the airways swell and secrete
mucus into the air spaces. Both these actions cause the
bronchi to narrow, a change that is called bronchocon-
striction. As a result, an asthmatic person has to make a
much greater effort to breathe.

Cells in the bronchial walls, called mast cells, release
certain substances that cause the bronchial muscle to con-
tract and stimulate mucus formation. These substances,
which include histamine and a group of chemicals called
leukotrienes, also bring white blood cells into the area.
Many patients with asthma are prone to react to substances
such as pollen, dust, or animal dander; these are called al-
lergens. Many people with asthma do not realize that aller-
gens are triggering their attacks. On the other hand, asthma
also affects many patients who are not allergic in this way.

Asthma usually begins in childhood or adolescence,
but it also may first appear in adult life. While the symp-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

toms may be similar, certain important aspects of asthma
are different in children and adults. When asthma begins
in childhood, it often does so in a child who is likely, for
genetic reasons, to become sensitized to common aller-
gens in the environment. Such a child is known as an
atopic person. In 2004, scientists in Helsinki, Finland,
identified two new genes that cause atopic asthma. The
discovery might lead to earlier prediction of asthma in
children and adults. When these children are exposed to
dust, animal proteins, fungi, or other potential allergens,
they produce a type of antibody that is intended to engulf
and destroy the foreign materials. This has the effect of
making the airway cells sensitive to particular materials.
Further exposure can lead rapidly to an asthmatic re-
sponse. This condition of atopy is present in at least one
third and as many as one half of the general population.
When an infant or young child wheezes during viral in-
fections, the presence of allergy (in the child or a close
relative) is a clue that asthma may well continue
throughout childhood.

Allergenic materials may also play a role when
adults become asthmatic. Asthma can start at any age
and in a wide variety of situations. Many adults who are
not allergic have such conditions as sinusitis or nasal
polyps, or they may be sensitive to aspirin and related
drugs. Another major source of adult asthma is exposure
at work to animal products, certain forms of plastic,
wood dust, metals, and environmental pollution.

Causes & symptoms

In most cases, asthma is caused by inhaling an aller-
gen that sets off the chain of biochemical and tissue
changes leading to airway inflammation, bronchocon-
striction, and wheezing. Because avoiding (or at least
minimizing) exposure is the most effective way of treat-
ing asthma, it is vital to identify which allergen or irri-
tant is causing symptoms in a particular patient. Once
asthma is present, symptoms can be set off or made
worse if the patient also has rhinitis (inflammation of
the lining of the nose) or sinusitis. When, for some rea-
son, stomach acid passes back up the esophagus in a re-
action called acid reflux, this condition also can make
asthma worse. In addition, a viral infection of the respi-
ratory tract can inflame an asthmatic reaction. Aspirin
and drugs called beta-blockers, often used to treat high
blood pressure, also can worsen the symptoms of asth-
ma. But the most important inhaled allergens giving rise
to attacks of asthma are:

• animal dander

• dust mites

• fungi (molds) that grow indoors

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

INHALED ALLERGENS

MOST OFTEN TRIGGERING ASTHMA ATTACKS

Air pollutants
Animal dander
Cockroach allergens
Dust mites
Indoor fungi (molds)

Occupational allergens such as chemicals, fumes,
particles of industrial materials

Pollen

• cockroach allergens

• pollen

• occupational exposure to chemicals, fumes, or particles
of industrial materials

• tobacco smoke

• air pollutants

In addition, there are three important factors that
regularly produce attacks in certain asthmatic patients,
and they may sometimes be the sole cause of symptoms.
They are:

• inhaling cold air (cold-induced asthma)

• exercise-induced asthma (in certain children, asthma
attacks are caused simply by exercising)

• stress or a high level of anxiety

Wheezing often is obvious, but mild asthmatic at-
tacks may be confirmed when the physician listens to the
patient’s chest with a stethoscope. Besides wheezing and
being short of breath, the patient may cough or report a
feeling of tightness in the chest. Children may have itch-
ing on their back or neck at the start of an attack. Wheez-
ing often is loudest when the patient exhales. Some asth-
matics are free of symptoms most of the time but may
occasionally be short of breath for a brief time. Others
spend much of their days (and nights) coughing and
wheezing until properly treated. Crying or even laughing
may bring on an attack. Severe episodes often are seen
when the patient gets a viral respiratory tract infection or
is exposed to a heavy load of an allergen or irritant.
Asthmatic attacks may last only a few minutes or can go
on for hours or even days. Being short of breath may
cause a patient to become very anxious, sit upright, lean
forward, and use the muscles of the neck and chest wall
to help breathe. The patient may be able to say only a
few words at a time before stopping to take a breath.
Confusion and a bluish tint to the skin are clues that the

137

Asthma

Source: “Occupational Asthma.” Occupational Safety and
Health Administration, U.S. Department of Labor.
http://www.osha.gov/oshinfo/priorities/asthma.html (Stan-
ley Publishing. Reproduced by permission.)

oxygen supply is much too low and that emergency treat-
ment is needed. In a severe attack, some of the air sacs in
the lung may rupture so that air collects within the chest,
which makes it even harder to breathe. The good news is
that almost always, even patients with the most severe at-
tacks will recover completely.

Diagnosis

Apart from listening to the patient’s chest, the exam-
iner should look for maximum chest expansion while
taking in air. Hunched shoulders and contracting neck
muscles are other signs of narrowed airways. Nasal
polyps or increased amounts of nasal secretions are often
noted in asthmatic patients. Skin changes, like dermati-
tis or eczema, are a clue that the patient has allergic
problems. Inquiring about a family history of asthma or
allergies can be a valuable indicator of asthma. A test
called spirometry measures how rapidly air is exhaled
and how much is retained in the lungs. Repeating the test
after the patient inhales a drug that widens the air pas-
sages (a bronchodilator) will show whether the narrow-
ing of the airway is reversible, which is a very typical
finding in asthma. Often patients use a related instru-
ment, called a peak flow meter, to keep track of asthma
severity when at home.

Frequently, it is difficult to determine what is trig-
gering asthma attacks. Allergy skin testing may be
used, although an allergic skin response does not al-
ways mean that the allergen being tested is causing the
asthma. Also, the body’s immune system produces an
antibody to fight off the allergen, and the amount of an-
tibody can be measured by a blood test. The blood test

138

will show how sensitive the patient is to a particular al-
lergen. If the diagnosis is still in doubt, the patient can
inhale a suspect allergen while using a spirometer to
detect airway narrowing. Spirometry also can be re-
peated after a bout of exercise if exercise-induced asth-
ma is a possibility. A chest x-ray will help rule out
other disorders.

Treatment

There are many alternative treatments available for
asthma that have shown promising results. One strong
argument for these treatments is that they try to avoid
the drugs that allopathic treatment (combating disease
with remedies to produce effects different from those
produced by the disease) relies upon, which can be toxic
and addictive. Mainstream journals have reported on the
toxicity of asthma pharmaceuticals. A 1995 New
Zealand study showed that before 1940, death from
asthma was very low, but that the death rate promptly
increased with the introduction of bronchodilators. The
New England Journal of Medicine in 1992 reported that
albuterol and other asthma drugs cause the lungs to de-
teriorate when used regularly. A 1989 study in the An-
nals of Internal Medicine showed that respiratory thera-
pists, who are exposed to bronchodilator sprays, devel-
op asthma five times more often than other healthcare
professionals, which could imply that the drugs them-
selves may induce asthma. Theophylline, another popu-
lar drug, has been reported to cause personality changes
in users. Steroids can also have negative effects on
many systems in the body, particularly the hormonal
system. Thus, natural and non-toxic methods for treat-
ing asthma are the preferred first choice of alternative
practitioners, while drugs are used to manage extreme
cases and emergencies.

Alternative medicine tends to view asthma as the
body’s protective reaction to environmental agents and
pollutants. As such, the treatment goal is often to restore
balance to and strengthen the entire body and provide spe-
cific support to the lungs, immune and hormonal systems.
Asthma sufferers can help by keeping a diary of asthma
attacks in order to determine environmental and emotional
factors that may be contributing to their condition.

Alternative treatments have minimal side effects, are
generally inexpensive, and are convenient forms of self-
treatment. They also can be used alongside allopathic
treatments to improve their effectiveness and lessen their
negative side effects.

Dietary and nutritional therapies

Some alternative practitioners recommend cutting
down on or eliminating dairy products from the diet, as

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

In normal bronchioles the airway
is open and unobstructed.

During an attack, the bronchioles of an
asthma sufferer are constricted by bands
of muscle around them. They may be
further obstructed by increased mucus
production and tissue inflammation.

A comparison of normal bronchioles and those of an asthma sufferer. (Illustration by Hans & Cassidy. The Gale Group.)

these increase mucus secretion in the lungs and are
sources of food allergies. Other recommendations in-
clude avoiding processed foods, refined starches and
sugars, and foods with artificial additives and sulfites.
Diets should be high in fresh fruits, vegetables, and
whole grains, and low in salt. Asthma sufferers should
experiment with their diets to determine if food allergies
are playing a role in their asthma. Some studies have
shown that a sustained vegan (zero animal foods) diet
can be effective for asthma, as it does not contain the an-
imal products that frequently cause food allergies and
contain chemical additives. A vegan diet also eliminates
a fatty acid called arachidonic acid, which is found in an-
imal products and is believed to contribute to allergic re-
actions. A 1985 Swedish study showed that 92% of pa-
tients with asthma improved significantly after one year
on a vegan diet. On the other hand, some people feel

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

weaker on a vegan diet. In addition, many people are al-
lergic to vegetables rather than to meat.

Plenty of water should also be drunk by asthma suf-
ferers, as water helps to keep the passages of the lungs
moist. Onions and garlic contain quercetin, a flavonoid
(a chemical compound/biological response modifier)
that inhibits the release of histamine, and should be a
part of an asthmatic’s diet. Quercetin also is available as
a supplement, and should be taken with the digestive en-
zyme bromelain to increase its absorption.

As nutritional therapy, vitamins A, C and E have
been touted as important. Also, the B complex vitamins,
particularly B 6 and B 12 , may be helpful for asthma, as
well as magnesium, selenium, and an omega-3 fatty
acid supplement such as flaxseed oil. A good multivita-
min supplement also is recommended. In 2004, a study

139

Asthma

of supplements at Cornell University showed that high
levels of beta-carotene and vitamin C along with seleni-
um lowered risk of asthma. However, the same study
found that vitamin E had no effect.

Herbal remedies

Chinese medicine has traditionally used ma huang,
or ephedra, for asthma attacks. It contains ephedrine,
which is a bronchodilator used in many drugs. However,
the U.S. Food and Drug Administration (FDA) issued a
ban on the sale of ephedra that took effect in April 2004
because it was shown to raise blood pressure and stress
the circulatory system, resulting in heart attacks and
strokes for some users. Ginkgo has been shown to reduce
the frequency of asthma attacks, and licorice is used in
Chinese medicine as a natural decongestant and expecto-
rant. There are many formulas used in traditional Chi-
nese medicine to prevent or ease asthma attacks, de-
pending on the specific Chinese diagnosis given by the
practitioner. For example, ma huang is used to treat so-
called “wind-cold” respiratory ailments.

Other herbs used for asthma include lobelia, also
called Indian tobacco; nettle, which contains a natural
antihistamine; thyme; elecampane mullein: feverfew;
passionflower: saw palmetto: and Asian ginseng. Coffee
and tea have been shown to reduce the severity of asthma
attacks because caffeine works as a bronchodilator. Tea
also contains minute amounts of theophylline, a major
drug used for asthma. Ayurvedic (traditional East Indian)
medicine recommends the herb Tylophora asthmatica.

Mind/body approaches

Mind/body medicine has demonstrated that psy-
chological factors play a complex role in asthma. Emo-
tional stress can trigger asthma attacks. Mind/body tech-
niques strive to reduce stress and help asthma sufferers
manage the psychological component of their condition.
A 1992 study by Dr. Erik Peper at the Institute for Holis-
tic Healing Studies in San Francisco used biofeedback,
a treatment method that uses monitors to reveal physio-
logical information to patients, to teach relaxation and
deep breathing methods to 21 asthma patients. Eighty
percent of them subsequently reported fewer attacks and
emergency room visits. A 1993 study by Kaiser Perma-
nente in Northern California worked with 323 adults
with moderate to severe asthma. Half the patients got
standard care while the other half participated in support
groups. The support group patients had cut their asthma-
related doctor visits in half after two years. Some other
mind/body techniques used for asthma include relax-
ation methods, meditation, hypnotherapy,, mental
imaging, psychotherapy, and visualization.

140

Yoga and breathing methods

Studies have shown that yoga significantly helps
asthma sufferers, with exercises specifically designed to
expand the lungs, promote deep breathing, and reduce
stress. Pranayama is the yogic science of breathing,
which includes hundreds of deep breathing techniques.
These breathing exercises should be done daily as part of
any treatment program for asthma, as they are a very ef-
fective and inexpensive measure.

Controlled exercise

Many people believe that those with asthma should
not exercise. This is particularly true among parents of
children with asthma. In a 2004 study, researchers re-
ported that 20% of children with asthma do not get
enough exercise. Many parents believe it is dangerous
for their children with asthma to exercise, but physical
activity benefits all children, including those with asth-
ma. Parents should work with the child’s healthcare
provider and any coach or organized sport leader to care-
fully monitor his or her activities.

Acupuncture

Acupuncture can be an effective treatment for asth-
ma. It is used in traditional Chinese medicine along with
dietary changes. Acupressure can also be used as a self-
treatment for asthma attacks and prevention. The Lung 1
points, used to stimulate breathing, can be easily found
on the chest. These are sensitive, often knotted spots on
the muscles that run horizontally about an inch below the
collarbone, and about two inches from the center of the
chest. The points can be pressed in a circular manner
with the thumbs, while the head is allowed to hang for-
ward and the patient takes slow, deep breaths. Reflexolo-
gy also uses particular acupressure points on the hands
and feet that are believed to stimulate the lungs.

Other treatments

Aromatherapists recommend eucalyptus, lavender,
rosemary, and chamomile as fragrances that promote
free breathing. In Japan, a common treatment for asthma
is administering cold baths. This form of hydrotherapy
has been demonstrated to open constricted air passages.
Massage therapies such as Rolfing can help asthma suf-
ferers as well, as they strive to open and increase circula-
tion in the chest area. Homeopathy uses the remedies
Arsenicum album, Kali carbonicum, Natrum sul-
phuricum, and Aconite.

Allopathic treatment

Allopaths recommend that asthma patients should
be periodically examined and have their lung functions

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

measured by spirometry. The goals are to prevent trou-
blesome symptoms, to maintain lung function as close to
normal as possible, and to allow patients to pursue their
normal activities, including those requiring exertion. The
best drug therapy is that which controls asthmatic symp-
toms while causing few or no side effects.

Drugs

The chief methylxanthine drug is theophylline. It
may exert some anti-inflammatory effect and is especial-
ly helpful in controlling nighttime symptoms of asthma.
When, for some reason, a patient cannot use an inhaler
to maintain long-term control, sustained-release theo-
phylline is a good alternative. The blood levels of the
drug must be measured periodically, as too high a dose
can cause an abnormal heart rhythm or convulsions.

Beta-receptor agonists (drugs that trigger cell re-
sponse) are bronchodilators. They are the drugs of
choice for relieving sudden attacks of asthma and for
preventing attacks from being triggered by exercise.
Some agonists, such as albuterol, act mainly in lung cells
and have little effect on the heart and other organs. These
drugs generally start acting within minutes, but their ef-
fects last only four to six hours. They may be taken by
mouth, inhaled, or injected. In 2004, a new lower con-
centration of albuterol was approved by the FDA for
children ages two to 12.

Steroids are drugs that resemble natural body hor-
mones. They block inflammation and are effective in re-
lieving symptoms of asthma. When steroids are taken by
inhalation for a long period, asthma attacks become less
frequent as the airways become less sensitive to aller-
gens. Steroids are the strongest medicine for asthma, and
can control even severe cases over the long term and
maintain good lung function. However, steroids can
cause numerous side effects, including bleeding from the
stomach, loss of calcium from bones, cataracts in the
eye, and a diabetes-like state. Patients using steroids for
lengthy periods may also have problems with wound
healing, may gain weight, and may suffer mental prob-
lems. In children, growth may be slowed. Besides being
inhaled, steroids may be taken by mouth or injected, to
rapidly control severe asthma.

Leukotriene modifiers are among a newer type of
drug that can be used in place of steroids, for older chil-
dren or adults who have a mild degree of persistent asth-
ma. They work by counteracting leukotrienes, which are
substances released by white blood cells in the lung that
cause the air passages to constrict and promote mucus
secretion. Other drugs include cromolyn and ne-
docromil, which are anti-inflammatory drugs that often
are used as initial treatments to prevent long-term asth-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

matic attacks in children. Montelukast sodium (Singu-
lair) is a drug taken daily that is used to help prevent
asthma attacks rather than to treat an acute attack. In
2004, the FDA approved an oral granule formula of Sin-
gulair for young children.

If a patient's asthma is caused by an allergen that
cannot be avoided and it has been difficult to control
symptoms by drugs, immunotherapy may be worth try-
ing. In a typical course of immunotherapy, increasing
amounts of the allergen are injected over a period of
three to five years, so that the body can build up an effec-
tive immune response. There is a risk that this treatment
may itself cause the airways to become narrowed and
bring on an asthmatic attack. Not all experts are enthusi-
astic about immunotherapy, although some studies have
shown that it reduces asthmatic symptoms caused by ex-
posure to dust mites, ragweed pollen, and cats.

Managing asthmatic attacks

A severe asthma attack should be treated as quickly
as possible. It is most important for a patient suffering an
acute attack to be given extra oxygen. Rarely, it may be
necessary to use a mechanical ventilator to help the pa-
tient breathe. A beta-receptor agonist is inhaled repeated-
ly or continuously. If the patient does not respond
promptly and completely, a steroid is given. A course of
steroid therapy, given after the attack is over, will make a
recurrence less likely.

Long-term allopathic treatment for asthma is based
on inhaling a beta-receptor agonist using a special in-
haler that meters the dose. Patients must be instructed in
proper use of an inhaler to be sure that it will deliver the
right amount of drug. Once asthma has been controlled
for several weeks or months, it is worth trying to cut
down on drug treatment, but this tapering must be done
gradually. The last drug added should be the first to be
reduced. Patients should be seen every one to six
months, depending on the frequency of attacks. Starting
treatment at home, rather than in a hospital, makes for
minimal delay and helps the patient to gain a sense of
control over the disease. All patients should be taught
how to monitor their symptoms so that they will know
when an attack is starting. Those with moderate or se-
vere asthma should know how to use a flow meter. They
also should have a written plan to follow if symptoms
suddenly become worse, including how to adjust their
medication and when to seek medical help. If more in-
tense treatment is necessary, it should be continued for
several days. When deciding whether a patient should be
hospitalized, the physician must take into account the pa-
tient's past history of acute attacks, severity of symp-
toms, current medication, and the availability of good
support at home.

141

Asthma

Expected results

Most patients with asthma respond well when the
best treatment or combination of treatments is found and
they are able to lead relatively normal lives. Patients who
take responsibility for their condition and experiment
with various treatments have good chances of keeping
symptoms minimal. Having urgent measures to control
asthma attacks and ongoing treatment to prevent attacks
are important as well. More than one half of affected
children stop having attacks by the time they reach 21
years of age. Many others have less frequent and less se-
vere attacks as they grow older. A small minority of pa-
tients will have progressively more trouble breathing.
Because they run a risk of going into respiratory failure,
they must receive intensive treatment.

Prevention

Prevention is extremely important in the treatment of
asthma, which includes eliminating all possible allergens
from the environment and diet. Homes and work areas
should be as dust and pollutant-free as possible. Areas
can be tested for allergens and high-quality air filters can
be installed to clean the air. If the patient is sensitive to a
family pet, removing the animal or at least keeping it out
of the bedroom (with the bedroom door closed) is ad-
vised. Keeping the pet away from carpets and upholstered
furniture, and removing all feathers also helps. To reduce
exposure to dust mites, it is recommended to remove
wall-to-wall carpeting, keep the humidity low, and use
special pillows and mattress covers. Cutting down on
stuffed toys, and washing them each week in hot water, is
advised for children with asthma. If cockroach allergen is
causing asthma attacks, controlling the roaches (using
traps or boric acid rather than chemicals) can help.

It is important to not to leave food or garbage exposed.
Keeping indoor air clean by vacuuming carpets once or
twice a week (with the asthmatic person absent), and
avoiding use of humidifiers is advised. Those with asthma
should avoid exposure to tobacco smoke and should not
exercise outside when air pollution levels are high. When
asthma is related to exposure at work, taking all precau-
tions, including wearing a mask and, if necessary, arrang-
ing to work in a safer area, is recommended. For chronic
sufferers who live in heavily polluted areas, moving to less
polluted regions may even be a viable alternative.

Resources

BOOKS

Bock, Steven J. Natural Relief for Your Child’ s Asthma. New

York: HarperPerennial, 1999.

Cutler, Ellen W. Winning the War against Asthma and Aller-
gies. New York: Delmar, 1998.

142

KEY TERMS

Allergen — A foreign substance that causes the air-
ways to narrow and produces symptoms of asth-
ma when inhaled.

Atopy — A state that makes persons more likely to
develop allergic reactions of any type, including
the inflammation and airway narrowing typical of
asthma.

Bronchodilator — A type of medication that acts to
open up bronchial tubes that have constricted in
an asthmatic attack.

Hypersensitivity — A condition in which very
small amounts of allergen can cause the airways
to constrict and bring on an asthmatic attack.
Leukotrienes — Substances that are produced by
white blood cells in response to antigens and con-
tribute to inflammatory and asthmatic reactions.

Pranayama — Breathing techniques taught in yoga.
Quercetin — A flavonoid (chemical compound/bi-
ological response modifier) found in onions and
garlic that may be a useful dietary supplement for
asthma patients.

Vegan diet — A vegetarian diet that excludes meat
and dairy products.

PERIODICALS

Allergy and Asthma Magazine. 702 Marshall St., Suite 61 1.
Redwood City, CA 94063. (605) 780-0546.

“Allergy Season Can Mean Trouble." Respiratory Therapeutics
Week (April 19, 2004):9.

“Asthma Antioxidants.” Better Nutrition (May 2004):26-27.

“Children with Asthma Inactive Due to Parental Health Beliefs,
Disease Severity.” Obesity, Fitness & Wellness Week (May
1, 2004):8.

“Identification of New Asthma Genes Demonstrates Model for
Improved Patient Care.” Drug Week (April 30, 2004):27.

McNamara, Daniel. “Singulair.” Family Practice News (Febru-
ary 1,2004): 108-109.

“Nine Million U.S. Children Diagnosed With Asthma, New
Report Finds." Medical Letter on the CDC & FDA (April
25, 2004): 11.

“Patent Granted for Pediatric Asthma Medication.” Health &
Medicine Week (April 12, 2004):552.

Ressel, Genevieve. “FDA Issues Regulation Prohibiting Sale of
Dietary Supplements Containing Ephedra.” American
Family Physician (March 15, 2004): 1343.

“U.S. Asthma Rates on the Rise." Medical Letter on the CDC
<6 FDA (March 28, 2004): 1 1.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ORGANIZATIONS

Asthma and Allergy Foundation of America. 1125 15th St.
NW, Suite 502. Washington, DC 20005. 800-7 ASTHMA.
<http://www.aafa.org>.

Center for Complementary and Alternative Medicine Research
in Asthma, Allergy, and Immunology. University of Cali-
fornia at Davis. 3150B Meyer Hall. Davis, CA 95616.
(916) 752-6575. <http://www-camra.ucdavis.edu>.

Douglas Dupler
Teresa G. Odle

Astigmatism

Definition

Astigmatism is a problem of visual distortion caused
by a misshapen cornea. The cornea acts as a focusing
lens for the eye. If the cornea does not have the proper
shape, the eye is unable to properly focus an image.
Most people have a certain degree of astigmatism. Cor-
rective measures are necessary only in cases where the
distortion is severe.

Description

Light rays entering a normal eye come to a point of
focus on the retina through a transparent, dome-shaped
layer called the cornea. In astigmatism there is unequal
curvature of the cornea, and the light rays come to focus at
more than one point on the retina. This causes the person
to see a blurred or doubled image. Astigmatism is usually
present at birth and may increase during childhood as the
eye tissue develops. Usually the degree of astigmatism re-
mains fairly constant throughout adulthood.

Causes & symptoms

It is unknown why some people develop a mis-
shapen cornea. It is possible that astigmatism is an inher-
ited trait. Factors such as stress, continual reading in dim
lighting, or excessive close-up work may also contribute
to the development of astigmatism. It is sometimes
caused by pressure from chalazion, a condition that
causes the eyelid to swell; from scars on the cornea; or
from keratoconus, a condition that involves swelling of
the cornea. The main symptom of astigmatism is blurred
or distorted vision. There may also be a history of
headaches, eye strain, fatigue, and double vision.

Diagnosis

The standard eye examination with a refraction
test, given by an optometrist or opthalmologist, is

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Horizontal line out of focus

Astigmatism corrected by lens

Astigmatism can be treated by the use of cylindrical lenses.
The lenses are shaped to counteract the shape of the sec-
tions of the cornea that are causing the difficulty. (Illustra-
tion by Electronic Illustrators Group.)

used to determine the presence of astigmatism. An in-
strument called a keratometer is used to measure the
cornea and calculate the shape of the required correc-
tive lens.

Treatment

The Bates method or other type of visual training
may be helpful in improving vision and reducing symp-
toms. The homeopathic remedies Ruta graveolens (from
common rue) and Apis mellifica (from the honey bee)
can be used to relieve eyestrain, one of the main symp-
toms and possible contributors to astigmatism.

Acupuncture treatment or Traditional Chinese
Medicine may help, as the liver system is connected to
eye functions. Certain treatments can strengthen and
correct the skewing of the Liver qi. ( Qi is the flow of
energy in the body. It is sometimes associated with cer-
tain organs.)

143

Astigmatism

Aston-Patterning

KEY TERMS

Chalazion — A condition in which clogging of the
Meibomiam gland causes a cyst inside the eyelid.

Keratoconus — A progressive condition in which
the cornea takes on a cone shape, causing major
changes in the eye's refractive power.

Refraction — The turning or bending of light waves
as the light passes from one medium or layer to
another. In the eye it means the ability of the eye
to bend light so that an image is focused onto the
retina.

Refractive surgery — Eye surgery to correct a de-
fect in the eye's ability to focus accurately on an
image.

Retina — The substance of the eye, made of nerve
tissue. It receives and transmits images to the
brain.

Allopathic treatment

Astigmatism can be most simply treated with either
eyeglasses or contact lenses. The lenses are made so as
to counteract the shape of the sections of cornea that are
causing difficulty. Contact lenses that are used to correct
astigmatism are called toric lenses. Hard contact lenses
may be better for correcting astigmatism than soft con-
tact lenses. In the case of keratoconus, a corneal trans-
plant is performed if the astigmatism cannot be corrected
with hard contact lenses.

Refractive surgery can be performed to correct the
curvature of the cornea. In radial keratotomy (RK) for
astigmatism, cuts are made into the cornea with a dia-
mond blade instrument. In photorefractive keratectomy
(PRK), a laser is used to improve the shape of the cornea
by removing micro-thin slices. Laser assisted in situ ker-
atomileusis (LASIK) is the most recently developed type
of refractive surgery. A flap of the cornea is cut with a
laser and then the corneal tissue underneath is shaved to
improve the shape.

Doctors continue to improve LASIK techniques. In
2002, a cross-cylinder method was developed in refrac-
tive surgery to help treat mixed astigmatism, one of the
most difficult types to treat. Refractive surgery requires
a high level of expertise. Anyone considering it should
make sure that the surgeon has a lot of experience in
the procedure. There should also be an in-depth discus-
sion of the possible side effects and risks of the proce-
dure. For instance, patients with flatter corneas seem to
come out of surgery with more light distortion than

144

those with curved corneas. Pupil size also may affect
surgery outcome.

Expected results

Effects of astigmatism can generally be greatly im-
proved with eyeglasses or contact lenses. Refractive
surgery may diminish the need for lenses or make them
unecessary altogether. The major risks of surgery include
chronic visual problems, injury to the eye tissue, infec-
tion, and over- or under-correction, which would still
leave some astigmatism. Complications may require the
use of medication or further surgery.

Resources

BOOKS

Lininger, Skye, ed. The Natural Pharmacy. Rocklin, Calif.:
Prima Health, 1998.

Newell, Frank W. Ophthalmology, Principles and Concepts.
8th ed. St. Louis: Mosby, 1996.

PERIODICALS

“Clues to LASIK Vision Problems (Risk of ‘Starbursts’).” Pre-
vention (June 2002): 161.

Meszaros, Liz. “Cross-Cylinder Technique Offers Many Bene-
fits. Little Trauma: Method to Correct Mixed Astigmatism
Minimizes Tissue Removal, not Ideal for High-Correction
Cases.” Ophthalmology Times (May 15, 2002): 41.

OTHER

“Refractive Surgery.” The Merck Manual Online. (December
2000).<http://www.merck.com/pubs/mmanual/section8/cha
pterl02/102c.htm/>.

Patience Paradox
Teresa G. Odle

Aston-Patterning

Definition

Aston-Patterning is an integrated system of move-
ment education, bodywork, ergonomic adjustments, and
fitness training that recognizes the relationship between
the body and mind for well being. It helps people who
seek a remedy from acute or chronic pain by teaching
them to improve postural and movement patterns.

Origins

Aston-Patterning is a process originated by Judith
Aston in 1977. After graduating from college with an
advanced degree in dance, Aston began working with

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

athletes, dancers, and actors in movement education pro-
grams in California. In 1968 she suffered injuries from
two automobile accidents. In seeking relief from pain,
she met Dr. Ida Rolf, the innovator of Rolfing. When
Aston recovered from her injuries, Rolf asked her to de-
velop a movement education program that would com-
plement the gains achieved with rolfing. She worked
with Rolf in creating this program from 1971 to 1977.

By 1977 Aston and Rolf’s interests and views of
bodywork had diverged. Aston left Rolf and established
her own techniques, which she called Aston-Patterning.
She has also developed a special program for older peo-
ple called the Aston-Patterning Fitness Program for Se-
niors. Today Aston-Patterning is a registered trademark
of the Aston Paradigm Corporation of which Judith
Aston is the director.

Benefits

Aston-Patterning assists people in finding more effi-
cient and less stressful ways of performing the simple
movements of everyday life to dissipate tension in the
body. This is done through massage, alteration of the en-
vironment, and fitness training.

Description

Seeking to solve movement problems, Aston-Pat-
terning helps make the most of their own unique body
types rather than trying to force them to conform to an
ideal. Unlike Rolfing, it doesn’t strive for linear symme-
try. Rather it works with asymmetry in the human body
to develop patterns of alignment and movement that feel
right to the individual. Aston also introduced the idea of
working in a three-dimensional spinal pattern.

Aston-Patterning sessions have four general compo-
nents. They are:

• A personal history that helps the practitioner assess the
client’s needs.

• Pre-testing, in which the practitioner and the client explore
patterns of movement and potential for improvement.

• Movement education and bodywork, including mas-
sage, myofacial release, and arthrokinetics, to help re-
lease tension and make new movement patterns easier.

• Post-testing, when pre-testing movements are repeated,
allowing the client to feel the changes that have taken
place and integrate them into daily life.

Aston-Patterning requires more participation from
the client than many bodywork techniques. The massage
aspect of Aston-Patterning is designed around a three-di-
mensional, non-compressive touch that releases patterns
of tension in the body. It is gentler than Rolfing. Myoki-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

JUDITH ASTON ?-

Judith Aston was born in Long Beach, California.
She graduated from University of California at Los An-
geles with a B.A. and a M.F.A. in dance. Her interest in
movement arose from working as a dancer. In 1963
Aston established her first movement education pro-
gram for dancers, actors, and athletes at Long Beach
City College.

Five years later, while recovering from injuries sus-
tained during two consecutive automobile accidents,
Aston met Ida Rolf, the developer of rolfing. Aston
began working for Rolf, teaching a movement educa-
tion program called Rolf-Aston Structural Patterning that
emphasized using the body with minimum effort and
maximum precision.

In time, Rolf and Aston's views on movement di-
verged, and the partnership was dissolved in 1977.
Aston formed her own company called the Aston Para-
digm Corporation in Lake Tahoe, California. This com-
pany provides training and certification for Aston practi-
tioners. She also began exploring how environmental
conditions affect body movement, foreshadowing the
ergonomic movement in the workplace that developed
in the 1990s. Over time, Aston has expanded her move-
ment work to include a fitness program for older adults.
Today, Judith Aston serves as director of Aston Paradigm
Corporation.

Tish Davidson

netics uses touch to release tension in the face and neck.
Arthrokinetics addresses tension at bones and joints.
This massage is accompanied by education about the es-
tablishment of new movement patterns.

In addition to Aston-Patterning sessions, clients are
also helped to examine their environment for factors, such
as seating or sleeping arrangements, that may limit their
body function and introduce tension. Finally, they may
choose to participate in the Aston fitness training program
that includes loosening techniques based on self-massage,
toning, stretching, and cardiovascular fitness.

Preparations

Since clients typically work with an Aston-Pattern-
ing practitioner for extended periods of time, it is impor-
tant that they feel comfortable with their specific practi-
tioner. Certified Aston practitioners recommend that
prospective clients make a get-acquainted visit before
enrolling in a course of treatment.

145

Aston-Patterning

Precautions

Aston-Patterning can be quite demanding. People
with any of the following diseases or disorders should
consult a physician before undertaking a course of
Aston-Patterning :

• Heart conditions.

• Diabetes. Because diabetes affects blood circulation,
diabetics taking Aston-Patterning should ask the practi-
tioner to avoid massage of the legs and feet.

• Carpal tunnel syndrome. Aston-Patterning may worsen
the pain associated with this disorder.

• Respiratory disorders, including asthma and emphysema.

• Osteoporosis. The deep tissue massage in Aston-Pat-
terning may cause hairline fractures in brittle bones.

• Bleeding disorders and other disorders requiring treat-
ment with anticoagulant or corticosteroid medications.
Drugs in these categories can make the tissues fragile.

• Disorders requiring medications that affect the sense of
balance.

• Post-traumatic stress syndromes. People suffering from
acute stress disorder, post-traumatic stress disorder,
or other emotional disorders related to abuse should
consult a psychotherapist as well as a physician before
undertaking any form of bodywork. The physical con-
tact involved in Aston-Patterning may cause flashbacks
or bring up emotional and psychological issues.

The Aston-Patterning program can, however, be mod-
ified to meet the needs of older adults, those in poor
health, or persons with special rehabilitation requirements.

Side effects

Most clients of Aston-Patterning report a diminution
of tension, improved ease of movement, and an enhanced
feeling of well-being. Some clients, however, do report
side effects, the most common being pain and exhaustion.
To minimize side effects, clients should give the practi-
tioner as much feedback as possible during sessions.

Research & general acceptance

Aston-Patterning is an outgrowth of Rolfing that has
been shown to be of benefit in a limited number of con-
trolled studies. Little controlled research has been done on
either the benefits or limitations of Aston-Patterning; as of
early 2003, no reports have been published in any peer-re-
viewed medical, alternative medical, or bodywork journals.
Its claims have been neither proven nor disproved, al-
though anecdotally many clients report relief from pain
and tension as well as improved body movement. Aston-

146

KEY TERMS

Bodywork — Any healing technique involving
hands-on massage or manipulation of the body.

Ergonomics — A branch of applied science that co-
ordinates the physical design and arrangement of
furniture, machines, and other features of a living
or working environment with the needs and re-
quirements of the individuals in that environment.
Rolfing — Developed by Dr. Ida Rolf (1896-1979),
rolfing is a systematic approach to relieving stress
patterns and dysfunctions in the body's structure
through the manipulation of the highly pliant myofa-
cial (connective) tissue. It assists the body in reorga-
nizing its major segments into vertical alignment.

Patterning is a member of the International Alliance of
Healthcare Educators (IAHE), and Judith Aston is a fre-
quent speaker at IAHE conferences. In addition, Aston’s
postural assessment workbook is used by practitioners in
other fields of bodywork and physical therapy.

Training & certification

The Aston Training Center in Incline Village, Nevada,
offers courses and certification and promotes a code of
ethics among its practitioners. Certification must renewed
annually. As of early 2003 there are certified Aston-Pat-
terning practitioners in fifteen states, with the largest con-
centrations in California, Colorado, and Washington.

Resources

BOOKS

Aston, Judith. Aston Postural Assessment Handbook: Skills for
Observing and Evaluating Body Patterns. San Diego, CA:
Academic Press, Inc., 1998.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part
I: Sound Mind, Sound Body. New York: Simon & Schus-
ter, 2002.

ORGANIZATIONS

Aston Training Center. P. O. Box 3568, Incline Village, NV
89450. (775) 831-8228. <http://www.aston-patteming.com>.
International Alliance of Healthcare Educators (IAHE). 11211 Pros-
perity Farms Road, D-325, Palm Beach Gardens, FL 34410.
(561) 622-4334 or (800) 311-9204. <http://www.iahe.com>.

OTHER

Rast, Mechthild. Book Review: Aston Postural Assessment Work-
book. Neuro-Developmental Treatment Association Network
January-February 2000. <http://www.ndta.org/edu>.

Tish Davidson
Rebecca J. Frey, PhD

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Astragalus

Description

Astragalus, also called milk vetch root, is the root of
the Astragalus membranaceus plant, which is a member
of the pea family. This perennial grows to a height of 2-A
ft. (5-10 cm). It has white or yellow flowers and leaves
with 10-18 pairs of leaflets. The large yellow taproots of
four- to seven-year-old plants are used for medicinal pur-
poses. Although there are many varieties in the Astra-
galus family. Astragalus membranaceus is the sole medi-
cinal type. The plant is found only in the grasslands and
mountains of central and western Asia, principally in
China, Taiwan, and Korea. Astragalus is a good source of
selenium, an antioxidant and immune system stimulant.

General use

Astragalus is called Huang Qi in traditional Chi-
nese medicine (TCM) and is considered to be an im-
portant tonic herb. It is used to strengthen what is
called the wei qi, or the defensive energy of the body
against disease. TCM identifies astragalus as being
helpful in conditions involving the Spleen, the Lungs,
and the Triple Burner. It is a warming tonic, and it im-
proves the functioning of the qi (the flow of energy in
the body), the Spleen, the Blood, and the fluids of the
body. Astragalus is recommended for Spleen deficien-
cy symptoms, such as diarrhea, fatigue, sweating,
and lack of appetite. It is used as a tonic for the Lungs
and is good for shortness of breath, asthma, and
chronic lung problems. Astragalus is prescribed for
arthritis, diarrhea, and nervous symptoms. It is often
given to people who are in a state of generally poor or
weakened health.

Astragalus is classified as an adaptogen, an herb that
increases the body’s endurance and resistance to a wide
array of physical, chemical, and biological stressors.
Adaptogens help normalize the functioning of various
body systems by affecting the action of hormones. Adap-
togens are usually beneficial in treating chronic condi-
tions. They have been found to enhance the immune re-
sponse, reduce inflammation, stabilize blood sugar, and
support the hormone systems, particularly the adrenal
and pituitary glands. Adaptogens should be used for an
extended period of time — at least six weeks.

Astragalus helps the body function at its best
level. It helps the body deal with stress and enhances
overall immune function. It has been shown to stimu-
late production and activation of the white blood cells,
which fight infection. It is highly recommended for
preventing and alleviating colds and flu. Astragalus

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

can be used to cure chronic weaknesses of the lungs.
Because it improves blood circulation and heart func-
tion, astragalus is useful in treating heart disease. It
has also been found to prevent or reduce blood clot-
ting. Astragalus can be taken as a tonic for the kidneys.
It has a diuretic (urine-producing) effect and so it
flushes out the urinary system. It is thus very effective
in treating kidney infections, proteinuria (too much
protein in the urine), chronic prostate problems, and
chronic urinary tract problems.

Astragalus is helpful to those taking chemotherapy
and radiation treatments. It reduces toxic side effects and
enhances therapeutic effects. Cancer patients who take
astragalus during or after cancer treatments tend to re-
cover more quickly from the ill effects of the treatment,
and they generally have better survival rates. This ap-
pears to be connected with the strengthening of the im-
mune system. Astragalus also stimulates the adrenal
glands, whose functions are suppressed in cancer. The
herb improves poor appetite, diarrhea, weakness, wast-
ing, and night sweats. This makes it helpful for cancer
patients as well as AIDS sufferers and those with other
debilitating diseases.

Astragalus is recommended as a tonic for the el-
derly. It protects cells from the aging process and
may diminish other negative effects of aging. For ex-
ample, it strengthens digestion, stimulates the ap-
petite, and helps improve mental functioning. Astra-
galus shows promise in the treatment of Alzheimer’s
disease. By itself or in combinations, it may be useful
in treating viral infections, hypoglycemia, diabetes
mellitus, chronic ulcers, insomnia,
hyperthyroidism, chronic fatigue syndrome, open
wounds, liver problems, sexual dysfunction, fertility
problems, and autoimmune diseases.

Preparations

Astragalus is available as a capsule, a tablet, a tinc-
ture, as a part of an herbal combination, as a prepared
tea, and as a sweet dried root that can be eaten or made
into tea. Traditionally, several slices of the root are often
added to soups and stews. A strong tea can be made by
boiling three ounces of astragalus root in three cups of
water and letting the mixture steep for at least five min-
utes. Two or three cups of the unheated tea can be taken
over the course of a day. In tincture form, 30-60 drops of
astragalus can be taken four times per day. Candied roots
can be purchased ready-made or prepared in the home.
Preparation involves combining four parts of the dried
root with one part honey in water, then simmering until
the herb is dried and brownish. In TCM, astragalus oint-
ments are used to heal wounds, particularly those that
are slow to heal.

147

Astragalus

Atherosclerosis

Resources

KEY TERMS

Adrenal glands — Glands atop the kidneys that
produce hormones.

Blood— In TCM, it is the fluid that transports phys-
ical and emotional nourishment.

Heat condition — A disease whose symptoms in-
clude fever, rashes, redness, dehydration, and in-
flammation.

Lungs — In TCM, the parts of the body associated
with breathing, such as the lungs and the skin. It
also regulates the movement of water and qi
through the body channels.

Qi — In the TCM system, the underlying force that
controls the body's movement, resistance to dis-
ease, use of nourishment, tissue integrity, and tem-
perature. It circulates through channels, or path-
ways, called meridians.

Spleen — In TCM, the system of organs that in-
cludes the pancreas, large muscles, the lips, the
eyelids, the lymph system, and the spleen. It also
includes the functions that extract nourishment
and convert it into qi and Blood.

Triple Burner — The pathways and relationships
between the Spleen, the Lungs and the Kidney.

Precautions

Since astragalus is a warming herb, its use should be
avoided in heat conditions, such as fevers or agitated
states. Astragalus membranaceus is the only species of
its family to have a medicinal use; other species may be
toxic. Therefore, local Western varieties should not be
used. Use only the root portion of the plant; other parts
of the plant may be poisonous.

Side effects

Sometimes individuals experience a slight stomach
upset or allergic reaction to astragalus. However, it is
generally a very safe herb, even at high doses.

Interactions

Astragalus increases the effectiveness of other herbs
when used in combinations. It is often used with Siberian
ginseng, Eleutherococcus senticosus; Echinacea spp.;
dong quai, Angelica sinensis; and Lingusticum wallichi.
Astragalus may interfere with the actions of diuretics, phe-
nobarbital, beta-blockers, and anticoagulants (substances
that prevent blood clotting). Users of these medications
should consult a healthcare provider before using the herb.

148

BOOKS

Graedon, Joe, and Teresa Graedon. The People's Pharmacy
Guide to Home and Herbal Remedies. New York: St. Mar-
tin’s Press, 1999.

Green, James. The Male Herbal: Health Care for Men and
Boys. Freedom, Calif.: Crossing Press, 1991.

Hart, Carol, and Magnolia Goh. Traditional Chinese Medicine:
The A-Z Guide to Natural Healing from the Orient. New
York: Dell. 1997.

OTHER

“Astragalus.” Go-Symmetry, <http://www.go-symmetry.com/
astragalus.htm.>

“Astragalus.” The Herbalist, <http://www.theherbalist.com/
astragal.htm.>

“Astragalus." HerbsHerbals.com. <http://www.herbsherbals.
com/astragalus.html.>

“Astragalus." Pro Health International, <http://www.planet.eon.
net/~wiggles/astra 1 galus.htm.>

Patience Paradox

Atherosclerosis

Definition

Atherosclerosis is the build up of plaque on the inside
of blood vessels. Atherosclerosis is often called arterioscle-
rosis, which is a general term for hardening of the arteries.

Description

Atherosclerosis, a progressive condition responsible
for most heart disease, is a type of hardening of the ar-
teries. It can be caused by normal aging processes, by
high blood pressure, and by some diseases, such as dia-
betes. Atherosclerosis can begin in the late teens, but it
usually takes decades for the signs and symptoms of the
disease to be apparent. Some people experience rapidly
progressing atherosclerosis in their 30s or later.

An artery is made up of several layers: an inner lin-
ing called the endothelium, an elastic membrane that al-
lows the artery to expand and contract, a layer of smooth
muscle, and a layer of connective tissue. Atherosclerosis
affects the inner lining of an artery. It is characterized by
plaque deposits that block the flow of blood. Plaque is
made of fatty substances, cholesterol, waste products
from the cells, calcium, iron, and fibrin, a material that
helps clot blood.

As plaque builds up in and around the cells of the
artery walls, they accumulate calcium. The innermost

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

layer thickens, the artery’s diameter is reduced, and
blood flow and oxygen delivery are decreased. Plaque
can rupture or crack open, causing the sudden formation
of a blood clot, called a thrombosis. As a result of throm-
bosis and/or the buildup of plaque, atherosclerosis can
cause a heart attack if it completely blocks the blood
flow in the coronary arteries. It can cause a stroke if it
completely blocks the carotid arteries of the brain. Ath-
erosclerosis can also occur in the arteries of the neck,
kidneys, thighs, and arms, and may lead to kidney fail-
ure, gangrene, and even death.

Causes & symptoms

It is thought that atherosclerosis is caused by the
body’s response to damage to the artery wall from cho-
lesterol, high blood pressure, and cigarette smoking. A
person who has all three of these risk factors is eight
times more likely to develop atherosclerosis than is a
person who has none. Physical inactivity, damage by ox-
idants, diabetes, and obesity are also risk factors for ath-
erosclerosis. High levels of the amino acid homocysteine
and abnormal levels of fats called lipoproteins also raise
the risk. Other risk factors include:

• High triglycerides. Most fat in food and in the body
takes the form of triglycerides. Blood triglyceride levels
above 400 mg/dL have been linked to atherosclerosis.

• Physical inactivity. Lack of exercise increases the risk
of atherosclerosis.

• Diabetes mellitus. The risk of developing atherosclero-
sis is seriously increased for diabetics and can be low-
ered by keeping diabetes under control. Many diabetics
die from heart attacks caused by atherosclerosis.

• Obesity. Excess weight increases the strain on the heart
and increases the risk of developing atherosclerosis,
even if no other risk factors are present.

• Heredity. People whose parents have coronary artery
disease, atherosclerosis, or stroke at an early age are at
increased risk.

• Sex. Before age 60, men are more likely to have heart
attacks than women.

• Age. Risk is higher in men who are 45 years of age and
older and women who are 55 years of age and older.

The symptoms of atherosclerosis differ depending
upon the location. They may involve:

• In the coronary (heart) arteries: chest pain, heart at-
tack, and sudden death.

• In the carotid arteries of the brain: sudden dizziness,
weakness, loss of speech, and blindness.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• In the femoral arteries of the legs: cramping and fa-
tigue in the calves of the legs when walking.

• In the renal arteries of the kidneys: high blood pressure
resistant to treatment.

Diagnosis

Physicians may be able to make a diagnosis of ath-
erosclerosis during a physical exam by means of a listen-
ing to the activity of the arteries and the heart with a
stethoscope and probing them with the hands. More de-
finitive tests are usually called for, however. These in-
clude an electrocardiogram, which shows the heart’s ac-
tivity; exercise electrocardiography, more familiarly
known as a stress test, conducted while the patient exer-
cises on a treadmill or a stationary bike; echocardiogra-
phy, a type of ultrasound using sound waves to create an
image of the heart’s chambers and valves; and ultra-
sonography to assess arteries of the neck and thighs.

Radionuclide angiography and thallium scanning
use radioactive material injected into the bloodstream.
These tests enable physicians to see the blood flow
through the coronary arteries and the heart chambers and
to record pictures of the heart. Coronary angiography is
the most accurate diagnostic method for artheroscerosis,
and it is also the only invasive procedure. A cardiologist
inserts a catheter equipped with a viewing device into a
blood vessel in the leg or arm and guides it into the heart.
A contrast dye makes the heart visible to x rays. Motion
pictures are taken of the dye flowing though the arteries,
and plaques and blockages are well defined.

Treatment

The most common treatments focus on dietary and
lifestyle changes to reduce cholesterol and other prob-
lems that contribute to atherosclerosis. Dietary modifica-
tions usually incorporate eating foods that are low in sat-
urated fats, cholesterol, sugar, and animal proteins. Foods
high in fiber, such as fresh fruits and vegetables, and
whole grains, are encouraged. By consuming fruits and
vegetables, the person also consumes helpful dietary an-
tioxidants, such as carotenoids found in vegetable pig-
ments, and bioflavenoids in fruit pigments. Liberal use of
onions and garlic is recommended, as well as eating fish,
especially cold-water fish, such as salmon. Smoking, al-
cohol, and coffee are to be avoided; and exercise is
strongly recommended. There are several well-known
programs, such as those created by Nathan and Robert
Pritikin and Dean Ornish, which are very helpful in set-
ting up and maintaining dietary and lifestyle programs.

Herbal remedies for atherosclerosis include garlic
( Allium sativum), ginger (Zingiber officinale), haw-

149

Atherosclerosis

thorn (Crataegus oxycantha), (Ginkgo biloba), and
Siberian ginseng root (Eleutherococcus senticosus).
Gugulipids, or myrrh (Commiphora molmol ) is highly
regarded for its ability to lower cholesterol and triglyc-
eride levels. Other herbs with this ability include alfalfa
(Medicago sativum), turmeric (Curcuma longa), (Panax
ginseng ), and fenugreek (Trigonella foenum-graecum).
Atherosclerosis is a complex condition. Therefore, a
knowledgeable practitioner of herbal healing should be
consulted for recommendations on the right combination
of herbs and dosages.

Chelation therapy involves injecting a drug called
EDTA and drug taken orally called DMSA, together
with nutrients into the bloodstream. It is thought to work
by either binding to the calcium in plaque and transport-
ing it for excretion, or by acting as an antioxidant, or by
both methods. It has shown some success, but it remains
a controversial method.

Several disciplines can offer helpful long-term
treatment strategies for those with atherosclerosis. A
knowledgeable practitioner should be consulted.
Ayurvedic medicine practitioners combine diet, herbal
remedies, relaxation, and exercises. A homeopath will
prescribe a treatment regimen based on a complete as-
sessment. A traditional Chinese medicine practitioner
may prescribe a combination of herbs such as siler
(Ledebouriellla divaricata), Platycodon grandiflorum.
Polygonum multiflorum, and Bupleurum chinense.
Acupuncture and massage may be recommended, par-
ticularly for the accompanying circulatory problems. A
homeopath will prescribe remedies based on an in-depth
interview and evaluation.

Stress is known to worsen blood pressure and ather-
osclerosis, and hasten the progression of the disease.
Therapeutic relaxation techniques are, therefore, helpful
adjuncts to treatment. Recommended approaches include
yoga, meditation, guided imagery, biofeedback, and
counseling. In fact, a 2002 study showed that transcen-
dental meditation, when combined with diet, exercise
and antioxidant food supplements, contributed to nearly
a 33% reduced long-term risk for heart attack and stroke
in some patients.

Allopathic treatment

Allopathic treatment includes medications, balloon
angioplasty, and coronary artery bypass surgery. Most of
the drugs prescribed for atherosclerosis seek to improve
conditions that contribute to the disease, such as high
cholesterol, blood clots, or high blood pressure.

Angioplasty and bypass surgery are invasive proce-
dures that improve blood flow in the coronary arteries.
Coronary angioplasty is performed by a cardiologist. It

150

KEY TERMS

Cardiac catheterization — A treatment using a nar-
row tube to clear out a blocked blood vessel.

Cholesterol — A fat-like substance that is made by
the human body and eaten in animal products.
Cholesterol is used to form cell membranes and
process hormones and vitamin D. High choles-
terol levels contribute to the development of ath-
erosclerosis.

Homocysteine — An amino acid involved with
protein use in the body. High levels have been im-
plicated in the development of atherosclerosis.

Triglyceride — A fat that comes from food or is
made from other energy sources in the body. Ele-
vated triglyceride levels contribute to the develop-
ment of atherosclerosis.

is a nonsurgical procedure in which a catheter tipped
with a balloon is threaded from a blood vessel in the
thigh into the blocked artery. When the balloon is inflat-
ed, it compresses the plaque and enlarges the blood ves-
sel to open the blocked artery. In one-third of patients,
the artery narrows again within six months. The proce-
dure may have to be repeated and a wire mesh stent may
be placed in the artery to help keep it open. In bypass
surgery, a detour is created with grafted or synthetic
blood vessels. The blood can then go around the block-
age. Other procedures may be used, including catheteri-
zation and laser treatments.

Expected results

Atherosclerosis can be successfully treated, but not
cured. Studies have shown that atherosclerosis can be
delayed, stopped, and even reversed by aggressively low-
ering cholesterol and changing the diet.

Prevention

A healthy lifestyle — eating right, regular exercise,
maintaining a healthy weight, not smoking, and control-
ling hypertension — can reduce the risk of developing ath-
erosclerosis, help keep the disease from progressing, and
sometimes cause it to regress. A 2002 study presented
promising news about the impact of simple exercise on
modifying the elasticity of one’s arteries. A small group
of healthy but sedentary postmenopausal women began
walking at a moderate pace for 40 to 45 minutes a day
five times a week. By the end of 12 weeks, 48% of the
women had restored elasticity to their carotid arteries.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Resources

BOOKS

American Heart Association and American Cancer Society, ed.
Living Well, Staying Well. New York and Toronto: American
Heart Association and American Cancer Society, 1996.

The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative & Conventional Treatments.
Virginia: Time-Life Books, 1997.

Shealy, C. Norman. The Complete Family Guide to Alternative
Medicine. New York: Barnes & Noble Books, 1996.

PERIODICALS

“Research Briefs: Meditation Reduces Atherosclerosis.” GP
(May 13, 2002): 4.

"Walking Aids Older Women’s Arterial Elasticity, Helping
Heart.” Women s Health Weekly (May 23, 2002): 3.

ORGANIZATIONS

American Heart Association, National Center. 7272 Greenville
Avenue, Dallas, TX 75231M596, <http://www.amhrt.org.>

National Heart, Lung, and Blood Institute. RO. Box 30105,
Bethesda, MD 20824-0105. <http://www.nhlbi.nih.gov/
nhlbi/nhlbi.htm.>

Patience Paradox
Teresa G. Odle

Athlete's foot

Definition

Athlete’s foot is a common fungus infection in
which the skin of the feet, especially on the sole and
toes, becomes itchy and sore, cracking and peeling away.
Athlete’s foot, also known as tinea pedis, can be difficult
to clear up completely.

Athlete’s foot received its common name because
the infection is often found among athletes. This is be-
cause the fungi flourish best in the around swimming
pools, showers, and locker rooms.

Description

Athlete’s foot is very common, so common that
most people will have at least one episode with this fun-
gal infection at least once in their lives. It is found more
often in adult males. In fact, symptoms that appears to be
athlete’s foot in young children are probably caused by
some other skin condition.

Causes & symptoms

Athlete’s foot is caused by a fungal infection that espe-
cially affects the skin between the toes. The fungi that cause

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Athlete’s foot fungus on toes of patient. (Custom Medical
Stock Photo. Reproduced by permission.)

athlete’s foot include Trichophyton ruhrum, T. mentagro-
phytes, and Epidermophyton floccosum. These fungi live
exclusively on dead body tissue, such as hair, the outer layer
of skin, and the nails. The fungus grows best in moist,
damp, dark places with poor ventilation. The problem is
rare in children and those who customarily go barefoot.

Most people carry fungus on their skin. However, it
will only flourish to the point of causing athlete’s foot if
conditions are right. The fungi multiply on the skin when it
is irritated, weakened, or continuously moist. Sweaty feet,
tight shoes, synthetic socks that do not absorb moisture
well, a warm climate, and not drying the feet well after
swimming or bathing, all contribute to the overgrowth of
the fungus. Symptoms include itchy, sore skin on the toes,
with scaling, inflammation, and blisters. Blisters that
break, exposing raw patches of tissue, can cause pain and
swelling. The infected feet also may have an unpleasant
smell. As the infection spreads, itching and burning may
worsen. In severe cases, the skin cracks and seeps fluid.
Sometimes a secondary bacterial infection is also present.

If it is not treated, athlete’s foot can spread to the
soles of the feet and toenails. Stubborn toenail infections,
called tinea unguium, may appear at the same time, with
crumbling, scaling, and thickened nails, and nail loss. The
infection can spread further if patients scratch and then
touch themselves elsewhere (especially in the groin or
under the arms). It is also possible to spread the infection
to other parts of the body via contaminated bed sheets,
towels, or clothing. Athlete’s foot is more severe and more
common in people taking antibiotics, corticosteroids, birth
control pills, drugs to suppress immune function, and in
people with obesity, AIDS, and diabetes mellitus.

Diagnosis

A dermatologist can diagnose the condition by
physical examination and by examining a preparation of

151

Athlete's foot

skin scrapings under a microscope. Not all foot rashes
are athlete’s foot, which is why a physician should diag-
nose the condition before any remedies are used. In
order to properly diagnose the infection, the physician
may do a fungal culture. Using nonprescription products
on a rash that is not athlete's foot could worsen the rash,
therefore, proper diagnosis is important.

Treatment

The infected foot should be kept well ventilated. A
foot bath containing cinnamon has been shown to slow
down the growth of certain molds and fungi, and is said
to be very effective in clearing up athlete’s foot. Eight to
ten broken cinnamon sticks are boiled in four cups of
water, simmered for five minutes, and then steeped for
45 minutes. The mixture can be then placed in a basin
and used daily to soak the feet.

Herbal remedies used externally to treat athlete’s
foot include goldenseal ( Hydrastis canadensis ), tea tree
oil ( Melaleuca spp.), myrrh ( Commiphora molmol ), gar-
lic (Allium sativa), oregano oil (though its smell is quite
pungent), and calendula. The affected area should be
swabbed with an herbal mixture twice daily or the feet
should be soaked in a herbal footbath. Pau d’arco, also
called taheebo or lapacho, can be used for athlete’s foot
as well. The tea bags can be soaked in water for about 10
minutes and then placed on the affected areas, or by mak-
ing a tincture and directly rubbing the tea onto the toes.

Aromatherapy may be helpful. Several drops of the
essential oils of tea tree, peppermint (Mentha piperita), or
chamomile (Matricaria recutita ), can be added to the bath
water. Chamomile may be applied directly to the toes.

Allopathic treatment

Simple cases of athlete’s foot usually respond to an-
tifungal creams or sprays, such as tolnaftate (Aftate or
Tinactin), clotrimazole, miconazole nitrate (Micatin
products), or Whitfield’s tincture made of salicylic acid
and benzoic acid. Athlete’s foot may be resistant to topi-
cal medication and should not be ignored. If the infec-
tion is resistant, the doctor may prescribe an oral antifun-
gal drug such as ketoconozole or griseofulvin. Untreated
athlete’s foot may lead to a secondary bacterial infection
in the skin cracks.

Expected results

Athlete’s foot usually responds well to treatment, but
it is important to complete the recommmended treatment,
even if the skin appears to be free of fungus; otherwise,
the infection could return. Tinea unguium may accompany
athlete’s foot. It is typically very hard to treat effectively.

152

KEY TERMS

Corticosteroids — Synthetic hormones which con-
trol nutritional processes in the body as well as
the function of several organ systems.

Prevention

A healthy diet should be maintained. Foods with a
high sugar content should be avoided, including undilut-
ed fruit juice, honey, and maple syrup.

Good personal hygiene and a few simple precau-
tions can help prevent athlete’s foot. These include:

• The feet should be washed daily; care should be taken
to avoid contact with other parts of the body.

• The feet should be kept dry, especially between toes.

• Tight shoes and shoes made of synthetic material
should not be worn.

• The feet need to be kept well ventilated, especially in
the summer; bare feet and sandals are recommended.

• Absorbent polypropylene or white cotton socks are rec-
ommended; they should be and changed often.

• Bathing shoes should be worn in public bathing or
showering areas.

• A good quality foot powder should be used to keep the
feet dry.

• If anyone in the family has athlete’s foot, towels,
floors, and shower stalls should be washed with hot
water and disinfectant after use.

Resources

BOOKS

Donahue, Peggy Jo. Relief from Chronic Skin Problems. New
York: Dell Publishing, 1992.

Orkin, Milton, Howard Maibach, and Mark Dahl. Dermatol-
ogy. Connecticut: McGraw-Hill Professional Publishing,
1991.

Stoffman, Phyllis. The Family Guide to Preventing and Treat-
ing 100 Infectious Illnesses. New York: John Wiley and
Sons, 1995.

Thompson, June, et al. Mosby’s Clinical Nursing. St. Louis:
Mosby, 1998.

ORGANIZATIONS

American Podiatric Medical Association. 9312 Old George-
town Rd., Bethesda, MD 20814.

Patience Paradox

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Atkins diet

Definition

The Atkins diet is a high-protein, high-fat, very low-
carbohydrate regimen. It emphasizes meat, cheese, and
eggs, while discouraging foods such as bread, pasta,
fruit, and sugar. It is a form of ketogenic diet.

Origins

Robert C. Atkins, a cardiologist and internist, devel-
oped the diet in the early 1970s. It first came to public at-
tention in 1972 with the publication of Dr. Atkins' Diet
Revolution. It quickly became a bestseller but unlike
most other fad diets, has remained popular. At last count,
it had sold more than 15 million copies worldwide. Since
then, Atkins authored a number of other books on his
diet theme before his accidental death in 2003.

Benefits

The primary benefit of the diet is rapid and substan-
tial weight loss. By restricting carbohydrate intake, the
body will bum more fat stored in the body. Since there
are no limits on the amount of calories or quantities of
foods allowed on the diet, there is little hunger between
meals. According to Atkins, the diet can alleviate symp-
toms of conditions such as fatigue, irritability,
headaches, depression, and some types of joint and
muscle pain.

Description

The regimen is a low-carbohydrate, or ketogenic
diet, characterized by initial rapid weight loss, usually
due to water loss. Drastically reducing the amount of
carbohydrate intake causes liver and muscle glycogen
loss, which has a strong but temporary diuretic effect.
Long-term weight loss is said to occur because with a
low amount of carbohydrate intake, the body burns
stored fat for energy.

The four-step diet starts with a two-week induction
program designed to rebalance an individual’s metabo-
lism. Unlimited amounts of fat and protein are allowed
but carbohydrate intake is restricted to 15-20 grams per
day. Foods allowed include butter, oil, meat, poultry,
fish, eggs, cheese, and cream. The daily amount of car-
bohydrates allowed equals about three cups of salad veg-
etables, such as lettuce, cucumbers, and celery.

The second stage is for ongoing weight loss. It allows
15-40 grams of carbohydrates a day. When the individual
is about 10 pounds from their desired weight, they begin
the pre-maintenance phase. This gradually adds one to

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

three servings a week of high carbohydrate foods, such as
a piece of fruit or slice of whole-wheat bread. When the
desired weight is reached, the maintenance stage begins. It
allows 40-60 grams of carbohydrates per day.

Preparations

No advance preparation is needed to go on the diet.
However, as with most diets, it is generally considered ap-
propriate to consult with a physician and to have a physi-
cal evaluation before starting such a nutritional regimen.
The evaluation should include blood tests to determine
levels of cholesterol, triglycerides, glucose, insulin, and
uric acid. A glucose tolerance test also is recommended.

Precautions

Adherence to the Atkins diet can result in vitamin
and mineral deficiencies. In his books, Atkins recom-
mends a wide range of nutritional supplements, includ-
ing a multi-vitamin. Among his recommendations,
Atkins suggests the following daily dosages: 300-600
micrograms (meg) of chromium picolinate, 100-400
milligrams (mg) of pantetheine, 200 meg of selenium,
and 450-675 meg of biotin.

The diet is not recommended for lacto-ovo vegetari-
ans, since it cannot be done as successfully without pro-
tein derived from animal products. Also, vegans cannot
follow this diet, since a vegan diet is too high in carbohy-
drates, according to Atkins. Instead, he recommends
vegetarians with a serious weight problem give up vege-
tarianism, or at least include fish in their diet. In 2003, a
physicians group warned that high-protein diets may
cause permanent kidney loss in anyone with reduced
kidney function. They also can increase people’s risk of
colon cancer and osteoporosis.

Side effects

According to Atkins, the diet causes no adverse side
effects. Many health care professionals disagree. In a
fact sheet for the Healthcare Reality Check Web site
(http://www.hcrc.org), Ellen Coleman, a registered dieti-
cian and author, said the diet may have serious side ef-
fects for some people. She said complications associated
with the diet include ketosis, dehydration, electrolyte
loss, calcium depletion, weakness, nausea, and kidney
problems. “It is certainly riskier for overweight individu-
als with medical problems such as heart disease, hyper-
tension, kidney disease, and diabetes than it is for over-
weight people with no health problems,” she said.

People with diabetes taking insulin are at risk of be-
coming hypoglycemic if they do not eat appropriate car-
bohydrates. Also, persons who exercise regularly may

153

Atkins diet

DR. ROBERT C. ATKINS 1930-2003

(APAA/ide World Photos. Reproduced by permission.)

Dr. Robert C. Atkins graduated from the University of
Michigan in 1951 and received his medical degree from
Cornell University Medical School in 1955 with a special-
ty in cardiology. As an internist and cardiologist he devel-
oped the Atkins diet in the early 1 970s. The diet is a keto-

genic diet — a high protein, high fat, and very low carbohy-
drate regimen resulting in ketosis. It emphasizes meat,
cheese, and eggs, while discouraging foods such as bread,
pasta, fruit, and sugar. It first came to public attention in
1 972 with the publication of Dr. Atkins' Diet Revolution.
The book quickly became a bestseller but unlike most
other fad diet books, this one has remained popular. At last
count, it had been reprinted 28 times and sold more than
10 million copies worldwide. Since then, Atkins has au-
thored a number of other books on his diet theme, includ-
ing Dr. Atkins' New Diet Revolution (1992), Dr. Atkins'
Quick and Easy New Diet Cookbook (1 997), and The Vita-
Nutrient Solution: Nature's Answer to Drugs (1 998).

During his life, Atkins saw about 60,000 patients in
his more than 30 years of practice. He also appeared on
numerous radio and television talk shows, had his own
syndicated radio program, Your Health Choices, and au-
thored the monthly newsletter Dr. Atkins' Health Revela-
tions. Atkins received the World Organization of Alterna-
tive Medicine's Recognition of Achievement Award and
was named the National Health Federation's Man of the
Year. He was the director of the Atkins Center for Com-
plementary Medicine which he founded in the early
1980s until his death in 2003. The center is located at
152 E. 55th St., New York, NY 10022.

Ken R. Wells

experience low energy levels and muscle fatigue from
low carbohydrate intake.

Research & general acceptance

Opinion from the general medical community re-
mains mixed on the Atkins diet, but is generally unfavor-
able. There have been no significant long-term scientific
studies on the diet. A number of leading medical and
health organizations, including the American Medical As-
sociation, American Dietetic Association (ADA), and the
American Heart Association oppose it. It is drastically
different than the dietary intakes recommended by the
U.S. Department of Agriculture and the National Insti-
tutes of Health. Much of the opposition is because the
diet lacks some vitamins and nutrients, and because it is
high in fat. In a hearing before the U.S. Congress on Feb-
ruary 24, 2000, an ADA representative called the Atkins
diet “hazardous” and said it lacked scientific credibility.

Just a month after Dr. Atkins’ death, two studies of-
fering scientific support of the diet’s claims emerged.
The research found that people lost weight without rais-

154

ing their cholesterol. However, one of the studies
showed that at the end of one year, dieters regained
much of the weight.

Training & certification

There is no formal training or certification required.

Resources

BOOKS

Atkins, Dr. Robert C. Dr. Atkins' Age-Defying Diet Revolution.

New York: St. Martin’s Press. 1999.

Atkins, Dr. Robert C. Dr. Atkins' Diet Revolution: The High
Calorie Way to Stay Thin Forever. New York: Bantam
Books. 1989.

Atkins, Dr. Robert C. Dr. Atkins’ New Diet Revolution. New
York City: Avon Books. 1992.

Atkins, Dr. Robert C. Dr. Atkins' Health Revolution: How
Complementary Medicine Can Extend Your Life. New
York: Bantam Books. 1990.

Atkins, Dr. Robert C. Dr. Atkins’ Vita-Nutrient Solution: Na-
ture’s Answer to Drugs. New York: Simon & Schuster.
1998.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Biotin — A B complex vitamin, found naturally in
yeast, liver, and egg yolks.

Carbohydrates — Neutral compounds of carbon,
hydrogen, and oxygen found in sugar, starches,
and cellulose.

Hypertension — Abnormally high arterial blood
pressure, which if left untreated can lead to heart
disease and stroke.

Ketogenic diet — A diet that supplies an abnormal-
ly high amount of fat, and small amounts of car-
bohydrates and protein.

Ketosis — An abnormal increase in ketones in the
body, usually found in people with uncontrolled
diabetes mellitus.

Pantetheine — A growth factor substance essential
in humans, and a constituent of coenzyme A.
Triglycerides — A blood fat lipid that increases the
risk for heart disease.

PERIODICALS

Alger, Alexandra. “Meat’s Neat.” Forbes (August 11, 1997):
129.

“Atkins Diet Vindicated But Long-term Success Questionable.”
Obesity, Fitness and Wellness Week (June 14, 2003): 25.

Carroll, Joanne. “The Ketogenic Diet: A Practical Guide for
Caregivers.” Journal of the American Dietetic Association
(March 1998): 316-321.

Cray, Dan, et al. “The Low-Carb Diet Craze.” Time (November
1, 1999): 72-79.

“Doctor Group Describes Dangers of Atkins Diet.” Obesity,
Fitness and Wellness Week (August 9, 2003): 33.

Gotthardt, Melissa Meyers. “The New Low-Carb Diet Craze.”
Cosmopolitan (February 2000): 148.

Hammock, Delia. “Dr. Atkins’ New Diet Revolution.” Good
Housekeeping (June 1997): 127.

Howe, Maggy. “Excess Pounds.” Country Living (November
1995): 60-61.

Merrell, Woodson. "How I Became a Low-Carb Believer.”
Time (November 1, 1999): 80.

Turner, Richard. “The Trendy Diet That Sizzles.” Newsweek
September 6, 1999): 60.

OTHER

Atkins Center for Complementary Medicine. 152 E. 55th St..
New York. NY 10022. 212-758-2110. http://www.atkins
center.com.

Ken R. Wells
Teresa G. Odle

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Atopic dermatitis see Eczema

Atractylodes

Description

Atractylodes is the dried or steam-dried rhizome
(rootstalk) of Atractylodes macrocephala or A. ovata ,
perennial north Asian herbs in the Compositae family. It
grows in mountain valleys, especially in China’s Zhe-
jiang province. It may also be cultivated. In autumn, it
presents magenta corolla blooms.

In Mandarin, atractylodes is called Bai Zhu, Bai Shu,
Yu Zhu, and Dong Zhu. The Cantonese term is Paak Sat ,
and the Japanese call it Byakujutsu. Common names in-
clude large-headed atractylodes, white atractylodes, and
white shu. Its pharmaceutical name, used to distinguish it
as a medicine, is Rhizoma Atractylodis, and it is one of
more than 500 plants recognized as official drugs in tradi-
tional Chinese medicine. Related species, A. lancea and
A. chinensis , both called black or gray atractylodes, are
also used medicinally for similar but distinct purposes.

General use

Practitioners of Chinese medicine believe that
atractylodes affects the Spleen and Stomach meridians,
or energy pathways in the body. Its medicinal properties
are considered warm, mildly bitter, and sweet.

Atractylodes is thought to dry dampness, strengthen
the Spleen or digestion, and promote diuresis, the forma-
tion and excretion of urine. It is used for diarrhea, gen-
eralized aching, mental fatigue, dizziness, lack of ap-
petite, vomiting, edema (accumulation of fluids), and
spontaneous sweating. It is also used to prevent miscar-
riage and to treat restless fetal movement. Other uses in-
clude restoring deficient digestion associated with poor
absorption, malnutrition, anorexia, metabolic acidosis,
hypogylcemia, and rheumatism. It has also been used to
treat tumors of the cervix, uterus, breast, and stomach.

According to traditional Chinese medicine, both white
and black atractylodes may be used for digestive and urinary
problems. Black atractylodes is more drying than white.
White atractylodes has the additional benefit of being a
“Spleen Qi tonic,” meaning that it rebuilds metabolic func-
tion by increasing nutrition, increasing energy, and regulat-
ing fluids. White atractylodes is also thought to have restora-
tive, normalizing effects on the digestive system and Liver.

Research on atractylodes has generally been conducted
in China and has focused on pharmacological investigation
and animal experiments. In-vitro and animal studies show it

155

Atractylodes

Attention-deficit hyperactivity disorder

KEY TERMS

Cold — In Chinese pathology, the term defines a
condition that has insufficient warmth, either ob-
jective (hypothermia) or subjective (feeling cold).

Decoction — A strong tea brewed for twenty to
thirty minutes.

Heat — In Chinese pathology, the term defines a
condition that has excessive heat, either objective
(fever, infection) or subjective (feeling hot).

Meridians — Energetic pathways inside the body
through which qi flows; also called channels.

Tincture — A solution of medicinal substance in alco-
hol, usually more or less diluted. Herb tinctures are
made by infusing the alcohol with plant material.

Qi — A Chinese medical term denoting active
physiological energy.

has significant diuretic, sedative, and hypoglycemic (lower-
ing of blood glucose) effects. Animal studies pinpoint the
essential oil as responsible for sedative effects. It also pro-
motes digestion and quells nausea and diarrhea.

Major chemical constituents include atractylone,
atractylol, butenolide B, acetoxyatractylon, hydroxya-
tractylon, and vitamin A.

Preparations

Atractylodes is not generally available in American
health food stores, but it can be found at most Chinese
pharmacies and Asian groceries. Good quality atracty-
lodes is large, firm, solid, aromatic, and has a yellowish
cross section.

The standard dose is 3-10 g as a decoction (strong tea)
or 1—4 ml of tincture. Doses of dried material are 3-12 g.

Atractylodes is commonly prescribed in conjunction
with moisture-removing drugs and digestants. Practition-
ers of Chinese medicine commonly also combine
atractylodes with other Chinese herbs. The following are
the major herbs with which it is combined and the symp-
toms for which the combinations are prescribed.

• Radix codonopsis ( Codonopsis pilosula, Dang Shen)
and rhizoma zingiberis ( Zingiber officinalis, Gan
Jiang , dried ginger root) for abdominal pain, disten-
tion, vomiting, and diarrhea.

• Fructus Immaturus Citri Aurantii ( Citrus aurantium,
Zhi Shi, unripened bitter orange) for reduced appetite
with abdominal distention and fullness due to Spleen
deficiency with qi stagnation.

156

•Gray or black atractylodes (Atractylodes japonica,
Cang Zhu ) for damp-cold painful obstruction or vagi-
nal discharge.

• Sclerotium Poriae Cocos ( Poria cocos; Fu Ling ; tucka-
hoe, poria, or Indian bread) and Ramulus Cinnamomi
Cassiae ( Cinnamomum cassia, Gui Zhi, cinnamon
twig) for congested fluids with distention of the chest
and edema due to Spleen deficiency.

• Astragalus (Astragalus memhranaceus, Huang Qi) and
Fructus Tritici ( Triticum aestivum, Fu Xiao Mai, name
wheat grain) for unrelenting spontaneous sweating.

• Ramulus Perillae (Perilla frutescens, Su Geng ) and
Pericarpium Citri Reticulatae (Citrus reticulata, Chen
Pi, aged tangerine rind) for restless fetus disorder with
qi stagnation giving rise to distention and fullness in
the chest and abdomen.

Precautions

According to tradition, atractylodes is contraindicat-
ed in the presence of deficient heat conditions.

Side effects

None noted.

Interactions

No interactions with pharmaceutical drugs have

been noted.

Resources

BOOKS

Bensky, Dan, and Andrew Gamble. Chinese Herbal Medicine:
Materia Meclica. Rev. ed. Seattle: Eastland Press, 1993.

Fan, Warner J-W. A Manual of Chinese Herbal Medicine: Prin-
ciples and Practice for Easy Reference. Boston: Shamb-
hala, 1996.

Holmes, Peter. Jade Remedies: A Chinese Herbal Reference for
the West. Boulder, Colo.: Snow Lotus Press, 1996.

Hsu, Hong-yen, et al. Oriental Materia Medica: A Concise
Guide. Long Beach, Calif.: Oriental Healing Arts Insti-
tute, 1986.

Erika Lenz

Attention-deficit
hyperactivity disorder

Definition

Attention-deficit hyperactivity disorder (ADHD) is
a developmental disorder characterized by distractibility,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

hyperactivity, impulsive behaviors, and the inability to
remain focused on tasks or activities.

Description

ADHD, also known as hyperkinetic disorder (HKD)
outside the United States, is estimated to affect 7% of
children ages six to 11, or about 1.6 million children in
the United States. It also affects about 4% of adults. The
disorder affects boys more often than girls. Although dif-
ficult to assess in infancy and toddlerhood, signs of
ADHD may begin to appear as early as age two or three,
but the symptom picture changes as adolescence ap-
proaches. Many symptoms, particularly hyperactivity,
diminish in early adulthood. However, impulsivity and
inattention problems remain with up to 50% of ADHD
individuals throughout their adult life.

Children with ADHD have short attention spans and
are easily bored and/or frustrated with tasks. Although
they may be quite intelligent, their lack of focus fre-
quently results in poor grades and difficulties in school.
ADHD children act impulsively, taking action first and
thinking later. They are constantly moving, running,
climbing, squirming, and fidgeting, but often have trou-
ble with gross and fine motor skills. As a result, they
may be physically clumsy and awkward. Their clumsi-
ness may extend to the social arena, where they are
sometimes shunned due to their impulsive and intrusive
behavior. Some critics argue that ADHD is a condition
created and diagnosed in the Western world, particular to
the environment of highly developed countries, since it is
not diagnosed in other cultures. These critics of the
ADHD diagnosis feel that medicating a child does not
address the true underlying problem. They also note that
there may not be a problem at all because children are
naturally active and impulsive.

Causes & symptoms

The causes of ADHD are not known. However, it ap-
pears that heredity plays a major role in the development
of ADHD. Children with an ADHD parent or sibling are
more likely to develop the disorder. Before birth, ADHD
children may have been exposed to poor maternal nutri-
tion, viral infections, or maternal substance abuse. In
early childhood, exposure to lead or other toxins can
cause ADHD-like symptoms. Traumatic brain injury or
neurological disorders also may trigger ADHD symp-
toms. Although the exact cause of ADHD is not known,
an imbalance of certain neurotransmitters (the chemicals
in the brain that send messages between nerve cells) is
believed to be the mechanism behind ADHD symptoms.

A widely publicized study conducted by Ben Fein-
gold in the early 1970s suggested that allergies to certain

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

foods and food additives caused the characteristic hyper-
activity of ADHD children. Although some children may
have adverse reactions to certain foods that can affect
their behavior (for example, a rash might temporarily
cause a child to be distracted from other tasks), carefully
controlled follow-up studies have uncovered no link be-
tween food allergies and ADHD. Another popularly held
misconception about food and ADHD is that eating
sugar causes hyperactive behavior. Again, studies have
shown no link between sugar intake and ADHD. It is im-
portant to note, however, that a nutritionally balanced
diet is important for normal development in all children.

People with ADHD suffer from a variety of symp-
toms. These symptoms include such things as distrac-
tion, not paying attention, inconsistency, forgetfulness of
even simple tasks, fidgeting, verbal impulsivity, and so
on. It is interesting to note that everyone suffers from
these symptoms at times, but an individual with ADHD
will have more of these symptoms more of the time.

Some doctors indicated immature symmetric tonic
neck reflex (STNR) as a possible cause of certain symp-
toms. Other studies in 1993 and 1994 showed a link be-
tween the disorder and diet, dyes, and preservatives. In
another study in 1996, ADHD was linked to maternal
smoking during pregnancy.

Psychologists and other mental health professionals
typically use the criteria listed in the Diagnostic and Sta-
tistical Manual of Mental Disorders, Fourth Edition
(DSM-IV) as a guideline for determining the presence of
ADHD. For a diagnosis of ADHD, DSM-IV requires the
presence of at least six of the following symptoms of
inattention, or six or more symptoms of hyperactivity
and impulsivity combined.

Inattention

• fails to pay close attention to detail or makes careless
mistakes in schoolwork or other activities

• has difficulty sustaining attention in tasks or activities

• does not appear to listen when spoken to

• does not follow through on instructions and does not
finish tasks

• has difficulty organizing tasks and activities

• avoids or dislikes tasks that require sustained mental
effort (like homework)

• is easily distracted

• is forgetful in daily activities

Hyperactivity

• fidgets with hands or feet or squirms in seat

• does not remain seated when expected to

157

Attention-deficit hyperactivity disorder

• runs or climbs excessively when inappropriate (in ado-
lescents and adults, feelings of restlessness)

• has difficulty playing quietly

• is constantly on the move

• talks excessively

Impulsivity

• blurts out answers before the question has been com-
pleted

• has difficulty waiting for his or her turn

• interrupts and/or intrudes on others

DSM-IV also requires that some symptoms develop
before age seven, and that they significantly impair func-
tioning in two or more settings (e.g., home and school) for
at least six months. Children who meet the symptom crite-
ria for inattention, but not for hyperactivity/impulsivity are
diagnosed with Attention-deficit/hyperactivity disorder,
predominantly inattentive type, commonly called ADD.
(Young girls with ADHD may not be diagnosed because
they have mainly this subtype of the disorder.)

Diagnosis

The first step in determining if a child has ADHD is
to consult with a pediatrician, a doctor who treats chil-
dren. The pediatrician can make an initial evaluation of
the child’s developmental maturity compared to other
children in his or her age group. The doctor also should
perform a comprehensive physical examination to rule
out any organic causes of ADHD symptoms, such as an
overactive thyroid or vision or hearing problems.

If no organic problem can be found, a psychologist, psy-
chiatrist, neurologist, neuropsychologist, or learning specialist
typically is consulted to perform a comprehensive ADHD as-
sessment. A complete medical, family, social, psychiatric, and
educational history is compiled from existing medical and
school records and from interviews with parents and teachers.
Interviews also may be conducted with the child, depending
on his or her age. Along with these interviews, several clinical
inventories also may be used, such as the Conners Rating
Scales (Teacher’s Questionnaire and Parent’s Questionnaire),
Child Behavior Checklist (CBCL), and the Achenbach Child
Behavior Rating Scales. These inventories provide valuable
information on the child’s behavior in different settings and
situations. In addition, the Wender Utah Rating Scale has been
adapted for use in diagnosing ADHD in adults.

It is important to note that mental disorders such as
depression and anxiety disorder can cause symptoms
similar to ADHD. A complete and comprehensive psychi-
atric assessment is critical to differentiate ADHD from
other possible mood and behavioral disorders. Bipolar
disorder, for example, may be misdiagnosed as ADHD.

158

Public schools are required by federal law to offer
free ADHD testing upon request. A pediatrician also can
provide a referral to a psychologist or pediatric specialist
for ADHD assessment. Parents should check with their
insurance plans to see if these services are covered.

Treatment

A 2003 survey showed that approximately 54% of
parents reported using complementary or alternative
medicine treatments for their children in the previous
year. Some parents reported turning to these therapies
because doctors don’t always agree on the ADHD diag-
nosis and cannot adequately explain how allopathic drug
treatments calm people and improve mental focus. Be-
havior modification therapy uses a reward system to re-
inforce good behavior as well as task completion and can
be used both in the classroom and at home. A tangible
reward such as a sticker may be given to the child every
time he completes a task or behaves in an acceptable
manner. A chart system may be used to display the stick-
ers and visually illustrate the child’s progress. When a
certain number of stickers are collected, the child may
trade them in for a bigger reward such as a trip to the zoo
or a day at the beach. The reward system stays in place
until the good behavior becomes ingrained.

A variation of this technique, cognitive-behavioral
therapy, works to decrease impulsive behavior by getting
the child to recognize the connection between thoughts
and behavior, and to change behavior by changing nega-
tive thinking patterns.

Individual psychotherapy can help ADHD children
build self-esteem, give them a place to discuss their worries
and anxieties, and help them gain insight into their behavior
and feelings. Family therapy also may be beneficial in help-
ing family members develop coping skills and work
through feelings of guilt or anger they may be experiencing.

ADHD children perform better within a familiar,
consistent, and structured routine with positive reinforce-
ments for good behavior and real consequences for bad.
Family, friends, and caretakers should be educated on
the special needs and behaviors of the ADHD child.
Communication between parents and teachers is espe-
cially critical to ensuring an ADHD child has an appro-
priate learning environment.

A number of alternative treatments exist for ADHD.
Although there is a lack of controlled studies to prove
their efficacy, proponents report that they are successful
in controlling symptoms in some ADHD patients. Some
of the more popular alternative treatments are listed.

• Electroencephalograph (EEG) biofeedback. By mea-
suring brain wave activity and teaching the ADHD pa-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

tient which type of brain wave is associated with atten-
tion, EEG biofeedback attempts to train patients to gen-
erate the desired brain wave activity.

• Dietary therapy. Based in part on the Feingold food al-
lergy diet, dietary therapy focuses on a nutritional plan
that is high in protein and complex carbohydrates and
free of white sugar and salicylate-containing foods
such as strawberries, tomatoes, and grapes.

• Herbal therapy. Herbal therapy uses a variety of natural
remedies to address the symptoms of ADHD. Ginkgo
( Gingko biloba) is used for memory and mental sharp-
ness and chamomile ( Matricaria recutita ) extract is
used for calming. The safety of herbal remedies has not
been demonstrated in controlled studies. For example,
it is known that gingko may affect blood coagulation,
but controlled studies have not yet evaluated the risk of
the effect.

• Vitamin and mineral supplements. Some vitamin and
mineral supplements that are thought to be effective by
some alternative practitioners include calcium, zinc,
magnesium, iron, inositol, trace minerals, blue-green
algae. Also recommended are the combined amino
acids GABA, glycine, taurine, L-glutamine, L-pheny-
lalanine, and L-tyrosine. In 2003, a study reported that
a combination of omega-3 and omega-6 fatty acids
supplements may help with cognitive and behavioral
symptoms of ADHD.

• Homeopathic medicine. This is probably the most effec-
tive alternative therapy for ADD and ADHD because it
treats the whole person at a core level. Constitutional
homeopathic care is most appropriate and requires con-
sulting with a well-trained homeopath who has experi-
ence working with ADD and ADHD individuals.

• Auricular acupuncture. A small study in 1997 indicat-
ed that this type of acupuncture therapy might be effec-
tive in some children.

Allopathic treatment

Psychosocial therapy, usually combined with medica-
tions, is the treatment approach of choice to alleviate
ADHD symptoms. Psychostimulants, such as dextroam-
phetamine (Dexedrine), pemoline (Cylert), and
methylphenidate (Ritalin) commonly are prescribed to
control hyperactive and impulsive behavior and increase
attention span. They work by stimulating the production of
certain neurotransmitters in the brain. Possible side effects
of stimulants include nervous tics, irregular heartbeat, loss
of appetite, and insomnia. However, the medications usu-
ally are well-tolerated and safe in most cases. But accord-
ing to Carolyn Chambers Clark, R.N., Ed.D., 25% of the
children with ADHD do not respond to stimulant drugs.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

In children who don’t respond well to stimulant
therapy, tricyclic antidepressants such as desipramine
(Norpramin, Pertofane) and amitriptyline (Elavil) are
frequently recommended. Reported side effects of these
drugs include persistent dry mouth, sedation, disorien-
tation, and irregular heartbeat (particularly with de-
sipramine). Other medications prescribed for ADHD
therapy include buproprion (Wellbutrin), an antidepres-
sant; fluoxetine (Prozac), an antidepressant; and carba-
mazepine (Tegretol, Atretol), an anticonvulsant drug.
Clonidine (Catapres), a medication for high blood pres-
sure, also has been used to control aggression and hyper-
activity in some ADHD children, although it should not
be used with Ritalin. A child's response to medication
will change with age and maturation, so ADHD symp-
toms should be monitored closely and prescriptions ad-
justed accordingly.

In mid-2003, the first new drug for treating ADHD
was about to become available. Called atomoxetine
(Strattera), it was planned to offer several advantages
over standard stimulants. First, atomoxetine is not a con-
trolled substance, so physicians can write prescriptions
for a larger number of pills and refills. Further, it doesn’t
have the potential for abuse that the stimulant drugs pose.

Expected results

Untreated, ADHD negatively affects a child’s social
and educational performance and can seriously damage
his or her sense of self-esteem. ADHD children have im-
paired relationships with their peers and may be looked
upon as social outcasts. They may be seen as slow learn-
ers or troublemakers in the classroom. Siblings and even
parents may develop resentful feelings toward the
ADHD child.

Some ADHD children also develop a conduct disor-
der problem. For those adolescents who have both ADHD
and a conduct disorder, up to 25% go on to develop anti-
social personality disorder and the criminal behavior,
substance abuse, and high rate of suicide attempts that are
symptomatic of it. Children diagnosed with ADHD also
are more likely to have a learning disorder, a mood disor-
der such as depression, or an anxiety disorder.

Approximately 70-80% of ADHD patients treated
with stimulant medication experience significant relief
from symptoms, at least in the short-term. Approximate-
ly half of ADHD children seem to “outgrow” the disor-
der in adolescence or early adulthood. The other half
will retain some or all symptoms of ADHD as adults.
With early identification and intervention, careful com-
pliance with a treatment program, and a supportive and
nurturing home and school environment, ADHD children
can flourish socially and academically.

159

Attention-deficit hyperactivity disorder

Aucklandia

KEY TERMS

Conduct disorder — A behavioral and emotional
disorder of childhood and adolescence. Children
with a conduct disorder act inappropriately, in-
fringe on the rights of others, and violate societal
norms.

Nervous tic — A repetitive, involuntary action,
such as the twitching of a muscle or repeated
blinking.

Resources

BOOKS

Alexander-Roberts, Colleen. The ADHD Parenting Handbook:
Practical Advice for Parents from Parents. Dallas: Taylor
Publishing Co., 1994.

American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders, 4th ed. Washington, DC:
American Psychiatric Press Inc., 1994.

Diller, Laurence H. Running on Ritalin: A Physician Reflects
on Children, Society, and Performance in a Pill. New
York: Bantam Books, 1998.

Hallowell, Edward M., and John J. Ratey. Driven to Distrac-
tion. New York: Pantheon Books, 1994.

Kennedy, Patricia, Leif Terdal, and Lydia Fusetti. The Hyper-
active Child Book. New York: St. Martin's Press, 1993.

Maxmen, Jerrold S., and Nicholas G. Ward. “Disorders Usually
First Diagnosed in Infancy, Childhood, or Adolescence.”
In Essential Psychopathology and Its Treatment, 2nd ed.
New York: W.W. Norton, 1995, 419-457.

Osman, Betty B. Learning Disabilities and ADHD: A Family
Guide to Living and Learning Together. New York: John
Wiley & Sons, 1997.

PERIODICAL

“Complementary, Alternative Medicine Being Used by Parents
for ADHD.” The Brown University Child and Adolescent
Psychopharmacology Update (August 2003): 1-3.

Gaby, Alan R. “Essential Fatty Acids for ADHD.” Townsend
Letter for Doctors and Patients (April 2003):43.

Glicken, Anita D. "Attention Deficit Disorder and the Pediatric
Patient: A Review.” Physician Assistant 2 1 . no. 4 (April
1997): 101-111.

Hallowell, Edward M. “What I've Learned from A.D.D." Psy-
chology Today 30, no. 3 (May-June 1997): 40-46.

Monaco, John E. “New Drug for ADHD." Pediatrics for Par-
ents (June 2003):7-l 1.

“New National ADHD Resource Center Opens in Maryland.”
Special Education Report (June 2003): 12.

“Parents Increasingly Seek Alternative ADHD Treatments.”
Mental Health Weekly (September 22, 2003):7.

Swanson, J.M., et al. “Attention-deficit Hyperactivity Disorder
and Hyperkinetic Disorder.” The Lancet 35 1 (February 7,
1997): 429-433.

160

ORGANIZATION

Children and Adults with Attention Deficit Disorder.
(CH.A.D.D.). 499 Northwest 70th Ave., Suite 101, Planta-
tion, FL 33317. (800) 233-4050. <http://www.chadd.org/.>
The National Attention Deficit Disorder Association. (ADDA).
9930 Johnnycake Ridge Rd., Suite 3E, Mentor, OH
44060. (800) 487-2282. <http://www.add.org/.>

The National Resource Center of ADHD. (800) 233-4050.
<http://www.help4adhd.org/.>

Kim Sharp
Teresa G. Odle

Aucklandia

Description

Aucklandia, also known as costus or Mu Xiang , is the
root of the plant Saussurea costus. Aucklandia has been
used for centuries in Chinese and Indian herbal healing.
More recently it has been used in Western aromatherapy.

Aucklandia comes from a perennial plant that grows
to about 6 ft (2 m) in height. It is native to northern India
and Pakistan. This plant is also cultivated in other parts
of India and in southwest China. The long, tapering root
is harvested and dried for healing.

In some regions of Asia, several other species of
plant are used interchangeably with Saussurea costus.
These include Saussurea lappa and Saussurea
vladimirus. Locally, aucklandia is also called kuth, kust,
kushta, qust-e-shereen, and patchak.

General use

Aucklandia is used in China and India to treat three
main categories of complaints that center around the diges-
tive system, the lungs, and infections. Aucklandia is used to
treat symptoms such as nausea, vomiting, diarrhea, colon
spasms, poor digestion, abdominal gas, and stomach pain.
In laboratory studies, aucklandia has been shown to be an
antispasmodic, accounting for its effectiveness against such
symptoms as nausea and diarrhea. It is also sometimes used
to treat gallstones and jaundice, although no scientific
studies have confirmed its effectiveness for these uses.

Aucklandia is used in many places in Asia to treat
asthma, bronchitis, and uncontrolled cough. The anti-
spasmodic component of the root extract causes the air-
ways to relax and open more widely so that breathing
becomes easier. This same property causes it to mildly
lower blood pressure by relaxing the artery walls. How-
ever, it does not lower blood pressure as effectively as
some other herbs.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

In India, aucklandia is used primarily as an antisep-
tic, an insecticide, and a fungicide. It is also said to be
effective against yeast infections. Some research sug-
gests that aucklandia may be effective against infections
such as cholera and typhoid.

A 1991 study published in the Journal of the Pak-
istani Medical Association found that oral doses of an
extract of the root of Saussurea lappa significantly re-
duced nematode infestation in children. Nematodes are
parasitic roundworms. Another 1998 study done in
Korea found that an extract of Saussurea lappa killed
tiny brine shrimp. One compound isolated in the brine
shrimp investigation is known to be moderately effective
in killing some types of human tumor cell types in labo-
ratory settings. It appears that the use of aucklandia as an
antiseptic has some basis in scientific fact.

Other uses of aucklandia that have not been investi-
gated in regulated scientific studies include using it as a
treatment for water retention and lung tumors. In addi-
tion to its medicinal uses, aucklandia is a fragrance and
fixative in perfumes, shampoo, and hair dye. It is used in
the Asian food industry to flavor alcoholic beverages,
soft drinks, and sweets.

Preparations

Aucklandia can be prepared as either a distilled ex-
tract or as an essential oil. The dried roots are chopped
fine and softened in warm water, then distilled with
steam. The resulting water-based distillate is then sub-
jected to a solvent extraction to remove the active ingre-
dients. The resulting yellow-brown fluid has a long-last-
ing woody or musty odor. In Chinese medicine, aucklan-
dia is classified as acrid and bitter.

Aucklandia is used in formulas to treat both diges-
tive and respiratory complaints. The best known of these
formulas is Mu Xiang Shun Qi Wan. It is used to relieve
pain and encourage digestion. Mu Xiang Shun Qi Wan is
also used to treat chronic hepatitis, newly developed cir-
rhosis of the liver, and abdominal pain. This formula is
commercially available as pills, with the recommended
dose of eight pills twice a day.

Several other common formulas contain aucklandia.
Ginseng and longan formula ( Gui Pi Tang ) is used to
treat gastrointestinal upsets and various kinds of physical
and emotional stress. Rhubarb and Scutellaria formula
(Li Dan Plan) is used to treat gallstones. Tang Gui and
indigo formula (Chien Chin Chih Tai Wan) is used to
treat vaginal discharge and vaginal infections, as well as
lower body pain.

The oil of aucklandia is more commonly used in
India than in China, and it is also used in Western aro-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Antispasmodic — A substance that relieves spasm
or uncontrolled contraction, usually of the smooth
or involuntary muscle of the arteries, intestines, or
the airways.

Distillate — When a substance is distilled (vapor-
ized and condensed to separate out different com-
pounds), the material that is obtained through that
process is called the distillate.

Yin aspects — Yin aspects are the opposite of yang
aspects and are represented by qualities such as
cold, stillness, darkness, and passiveness.

matherapy. It is applied externally or inhaled. The oil
also is used by the cosmetic and perfume industry, where
it blends well with other fragrances such as patchouli
and floral fragrances.

Precautions

In Chinese medicine, aucklandia should not be used
by people with deficient yin, which means people who
are dehydrated or have a lot of dryness.

Side effects

When used externally, aucklandia causes skin irrita-
tion (contact dermatitis) in some sensitive individuals.

Interactions

Aucklandia has been used safely in Asia as a medici-
nal herb and a food and cosmetic additive for centuries. It
is often used in conjunction with other herbs with no re-
ported interactions. Since aucklandia has been used al-
most exclusively in Asian medicine, there are no available
studies of its interactions with Western pharmaceuticals.

Resources

BOOKS

Lawless, Julia. The Illustrated Encyclopedia of Essential Oils.
Rockport, MA: Element, 1995.

Molony. David. Complete Guide to Chinese Herbal Medicine.
New York: Berkeley Books, 1998.

ORGANIZATIONS

American Association of Oriental Medicine (AAOM). 433
Front Street, Catasauqua, PA 18032. (610) 266-2433.

Tish Davidson

161

Aucklandia

Auditory integration training

Definition

Auditory integration training (AIT), is one specific
type of music/auditory therapy based upon the work of
French otolaryngologists Dr. Alfred Tomatis and Dr. Guy
Berard.

Origins

The premise upon which most auditory integration
programs are based is that distortion in how things are
heard contributes to commonly seen behavioral or learn-
ing disorders in children. Some of these disorders in-
clude attention deficit/hyperactive disorder (ADHD),
autism, dyslexia, and central auditory processing disor-
ders (CAPD). Training the patient to listen can stimulate
central and cortical organization.

Auditory integration is one facet of what audiolo-
gists call central auditory processing. The simplest defin-
ition of central auditory processing, or CAP, is Universi-
ty of Buffalo Professor of Audiology Jack Katz’s, which
is: “What we do with what we hear.” Central auditory in-
tegration is actually the perception of sound, including
the ability to attend to sound, to remember it, retaining it
in both the long- and short-term memory, to be able to
listen to sound selectively, and to localize it.

Guy Berard developed one of the programs com-
monly used. Berard’s auditory integration training con-
sists of twenty half-hour sessions spent listening to musi-
cal sounds via a stereophonic system. The music is ran-
dom, with filtered frequencies, and the person listens
through earphones. These sound waves vibrate and exer-
cise structures in the middle ear. This is normally done in
sessions twice a day for 10 days.

Alfred Tomatis is also the inventor of the Electronic
Ear. This device operates through a series of filters, and
reestablishes the dominance of the right ear in hearing. The
basis of Tomatis’ work is a series of principles that follow:

• The most important purpose of the ear is to adapt sound
waves into signals that charge the brain.

• Sound is conducted via both air and bone. It can be
considered something that nourishes the nervous sys-
tem, either stimulating or destimulating it.

• Just as seeing is not the same as looking, hearing is not
the same as listening. Hearing is passive. Listening is
active.

• A person's ability to listen affects all language develop-
ment for that person. This process influences every as-
pect of self-image and social development.

162

• The capacity to listen can be changed or improved
through auditory stimulation using musical and vocal
sounds at high frequencies.

• Communication begins in the womb. As early as the
beginning of the second trimester, fetuses can hear
sounds. These sounds literally cause the brain and ner-
vous system of the baby to develop.

Description

A quartet of CAP defects have been identified that

can unfavorably alter how each person processes sound.

Among these are:

• Phonetic decoding, a problem that occurs when the
brain incorrectly decodes what is being heard. Sounds
are unrecognizable, often because the person speaking
talks too fast.

• Tolerance-fading memory, a condition with little or
poor tolerance for background sounds.

•Auditory integration involves a person’s ability to put
together things heard with things seen. Characteristi-
cally there are long response delays and trouble with
phonics, or recognizing the symbols for sounds.

• The fourth problem area, often called auditory organi-
zation, overlaps the previous three. It is characterized
by disorganization in handling auditory and other infor-
mation.

Certain audiological tests are carried out to see if the

person has a CAP problem, and if so, how severe it is.

Other tests give more specific information regarding the

nature of the CAP problem. They include:

• Puretone air-conduction threshold testing, which mea-
sures peripheral hearing loss. If loss is found, then
bone-conduction testing, or evaluation of the vibration
of small bones in the inner ear, is also carried out.

• Word discrimination scores (WDS) determines a per-
son’s clarity in hearing ideal speech. This is done by
presenting 25-50 words at 40 decibels above the per-
son’s average sound threshold in each ear. Test scores
equal the percentage of words heard correctly.

• Immittance testing is made up of two parts, assessing
the status of, and the protective mechanisms of the
middle ear.

• Staggered sporadic word (SSW) testing delivers 40
compound words in an overlapping way at 50 decibels
above threshold to each ear of the person being tested.
This test provides expanded information that makes it
possible to break down CAP problems into the four
basic types.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ALFRED TOMATIS 1920-2001

(Photograph by V. Brynner. Gamma Liaison. Reproduced by
permission.)

Internationally renowned French otolaryngologist,
psychologist, educator and inventor Alfred Tomatis early-
on perceived the importance of sound and hearing. He
took his degree as a Doctor of Medicine from the Univer-
sity of Paris and specialized in ear, nose and throat medi-
cine. The son of two opera singers, Tomatis early in his
career treated some of his parents' fellow opera singers.
From these experiences with the sound of music, he de-

veloped the principle that has come to be known as the
Tomatis Effect, i.e. that the human voice can only sing
what it hears.

Tomatis has been called the Einstein of the ear. It
was his research that made the world aware that the ears
of an infant in utero are already functioning at four and
half months of age. Just as the umbilical cord provides
nourishment to the unborn infant's body, Tomatis postu-
lated that the sound of the mother's voice is also a nutri-
ent heard by the fetus. This sound literally charges and
stimulates the growth of the brain.

Dr. Tomatis took this further, into the realm of lan-
guage. Tomatis concluded that the need to communicate
and to be understood are among our most basic needs.
He was a pioneer in perceiving that language problems
convert into social problems for people. "Language is
what characterizes man and makes him different from
other creatures," Tomatis is quoted as saying. The tech-
niques he developed to teach people how to listen effec-
tively are internationally respected tools used in the treat-
ment of autism, attention-deficit disorder, and other
learning disabilities.

His listening program, the invention of the Electronic
Ear, and his work with the therapeutic use of sound and
music for the past fifty years have made Tomatis arguably
the best known and most successful ear specialist in the
world. There are more than two hundred Tomatis Centers
worldwide, treating a vast variety of problems related to
the ability to hear.

Joan Schonbeck

• Speech in noise discrimination (SN) testing is similar to
Staggered Sporadic Word testing except that other noise
is also added and the percentage correct in quiet is com-
pared with that correct when there is added noise.

• Phonemic synthesis (PS) determines serious learning
problems. The types of errors made in sounding out
written words or associating written letters with the
sounds they represent help in determining the type and
severity of CAP problems.

Benefits

Upon completion of an auditory integration training
program, the person’s hearing should be capable of per-
ceiving all frequencies at, or near, the same level. Total
improvement from this therapy, in both hearing and be-
havior, can take up to one year.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Research & general acceptance

Auditory integration training is based upon newly
learned information about the brain. Though brain structures
and connections are predetermined, probably by heredity,
another factor called plasticity also comes into play. Learn-
ing, we now know, continues from birth to death. Plasticity
is the ability of the brain to actually change its structuring
and connections through the process of learning.

Problems with auditory processing are now viewed
as having a wide-reaching ripple effect on our society. It
is estimated that 30-40% of children starting school
have language-learning skills that can be described as
poor. CAP difficulties are a factor in several different
learning disabilities. They affect not only academic suc-
cess, but also nearly every aspect of societal difficulties.
One example to illustrate this is a 1989 University of

163

Auditory integration training

Aura therapy

Buffalo study where CAP problems were found to be
present in a surprising 97% of youth inmates in an up-
state New York corrections facility.

Training & certification

Both Tomatis and Berard have certification pro-
grams in their therapies.

Resources

BOOKS

Katz, Jack, Ph.D., Wilma Laufer Gabbay, M.S., Deborah S.
Ungerleider, M.A., and Lorin Wilde, M.S. Handbook of
Clinical Audiology. Waverly Press, Inc., 1985.

PERIODICALS

Katz, Jack, Ph.D. “Central Auditory Processing Evaluation."
(1996).

Masters, M. Gay. “Speech and Language Management of
CAPD.” (1996).

Musiek, Frank, Ph.D. "Auditory Training: An Eclectic Ap-
proach.” American Journal of Audiology (1995).

OTHER

“Auditory Integration and Alfred Tomatis.” The Spectrum Cen-
ter. <http://listeningtraining.com/ (December 2000). >
Cooper, Rachel. “What is Auditory Integration Training?”
http://www.vision3d.com/adhd/ (December 2000).

Dejean, Valerie. About the Tomatis Method, 1997 . Tomatis Au-
ditory Training Spectrum Center, Bethseda, MD.

Masters, M. Gay and Jack Stecker Katz, N.A. Central Auditory
Processing Disorders: Characteristic Difficulties.

Miniseminar, 1994.

Joan Schonbeck

Aura therapy

Definition

Aura therapy is a healing technique based on read-
ing a person’s aura, or vital energy field, and then treat-
ing diseases revealed by the aura color or colors. Aura
therapy is generally considered a subtype of biofield
therapy, which is a form of energy therapy that utilizes
energies thought to reside in or emanate from the human
body (as distinct from electromagnetic energy therapies).
There are several variations of treatment, but in general
aura therapy emphasizes manipulating the aura energy
back into a positive balance.

Origins

The exact origin of aura therapy is unknown, but
historical references to it date back about 5,000 years.

164

East Indian, Chinese, Jewish, and Christian faiths all
have references to auras as energies that vibrate through
physical matter. The energies are seen as colors and rep-
resent such states of being emotional, mental, astral, and
celestial. Halos have also been considered a kind of aura.
Historically, it was believed that the special powers of a
psychic, mystic, or clairvoyant were needed to see auras.
Today, there are many New Age centers that teach the art
of aura reading and therapy.

In the late 1890s, the scientist and inventor Nicola
Tesla (1856-1943) became the first person to photograph
an aura. Auric photography took a big leap forward in
the late 1930s when Semyon and Valentina Kirlian intro-
duced a high-voltage imaging process that became
known as Kirlian photography. Although there have
been challenges to the use of Kirlian photography, the
process was designed to photograph aura energy emitted
by life forms, including plants, animals, and humans. A
newer variation is aura imaging photography, which uses
a special camera to take instant photos of a person’s
aura. The size, shape, and color of the aura can then be
analyzed to reveal specific physical, emotional, and
mental problems.

Types of aura therapy

Since the early 1970s, several different forms of
aura therapy have emerged within the alternative medi-
cine field. Some brief descriptions follow.

Aura color therapy

Aura color therapy is more closely related to light
therapy than to such other forms of aura therapy as ther-
apeutic touch. In aura color therapy, the proportions of
the colors in a person’s aura as well as their clarity or in-
tensity are analyzed and treated. Aura color therapists
maintain that the aura of a healthy person will have an
undistorted oval shape around the body, with clear lines
of light energy and a perfect balance of the seven colors
of the rainbow. Muddy colors, bulges or swirls in the en-
ergy lines, or an absence of any of the major colors signal
energy imbalances. For example, a depressed person will
have large amounts of blue and green in the aura with no
orange or yellow. A chronically angry person will have
too much red and little or no blue.

Color therapy treatment consists of adding extra col-
ors to a dull or depleted aura or using complementary
colors to correct a color imbalance in the aura. For exam-
ple, orange, which is the complementary color of blue,
would be used to treat the aura of a depressed person.
Several different techniques may be used to add or bal-
ance the colors, the most common being the use of col-
ored lights to irradiate the client’s body, or the placement

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

of colored gemstones on the client’s body while he or she
lies on the floor or on a massage table. In another varia-
tion of aura color therapy, the client is advised to wear
clothing in colors intended to balance or correct the aura.

Therapeutic touch (TT)

Therapeutic touch, or TT, is a form of energy thera-
py that was developed in the United States in 1972 by
Dora Kunz, a psychic healer, and Dolores Krieger, a pro-
fessor of nursing at New York University. In TT, the
practitioner alters the patient’s energy field through a
transfer of energy from his or her hands to the patient.
When illness occurs, it creates a disturbance or blockage
in the aura or vital energy field. The TT practitioner uses
her/his hands to discern the blockage or disturbance. Al-
though the technique is called “therapeutic touch,” there
is generally no touching of the client’s physical body,
only his or her energetic body or biofield. TT is usually
performed on fully clothed patients who are either lying
down on a flat surface or sitting up in a chair.

A therapeutic touch session consists of five steps or
phases. The first step is a period of meditation on the
practitioner’s part, to become spiritually centered and en-
ergized for the task of healing. The second step is assess-
ment or discernment of the energy imbalances in the pa-
tient’s aura. In this step, the TT practitioner holds his or
her hands about 2-3 inches above the patient’s body and
moves them in long, sweeping strokes from the patient’s
head downward to the feet. The practitioner may feel a
sense of warmth, heaviness, tingling, or similar cues, as
they are known in TT. The cues are thought to reveal the
location of the energy disturbances or imbalances. In the
third step, known as the unruffling process, the practi-
tioner removes the energy disturbances with downward
sweeping movements. In the fourth step, the practitioner
serves as a channel for the transfer of universal energy to
the patient. The fifth step consists of smoothing the pa-
tient’s energy field and restoring a symmetrical pattern
of energy flow. After the treatment, the patient rests for
10-15 minutes.

Tellington touch (Ttouch)

Tellington touch, which is also known as Ttouch, is an
interesting instance of an alternative therapy that began in
veterinary practice and was later extended to humans.
Ttouch was developed in England by Linda Tellington-
Jones, a graduate of Feldenkrais training. The Feldenkrais
method, which is usually considered a bodywork therapy,
originated with Dr. Moshe Feldenkrais (1904-1984), a
scientist and engineer who was also a judo instmctor. The
Feldenkrais method is based on redirecting the client’s ha-
bitual patterns of body movement, but it is unusual among

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

bodywork therapies in its emphasis on new patterns of
thinking and imagination as byproducts of the body’s reed-
ucation. Tellington-Jones, who was employed as a horse
trainer, began using Feldenkrais techniques on horses in
1975. In 1983 she developed the pattern of circular touch-
ing motions known as Tellington touch.

In the 1980s, Ttouch expanded from treating behav-
ioral problems in horses to treating cats, dogs, and other
household pets. In the 1990s, Ttouch was introduced into
nursing school curricula for the treatment of humans. It
has been used to treat patients suffering from such
chronic conditions as pain syndromes, Alzheimer’s dis-
ease, arthritis, and multiple sclerosis as well as patients
recovering from traumatic injuries or stroke. Ttouch is
growing in popularity among hospice nurses as an alter-
native treatment for patients facing death.

In Ttouch, the practitioner touches the client’s skin
but does not manipulate the underlying muscles or
bones. The practitioner imagines the face of a clock on
the client’s body and places a lightly curved finger at the
6-o’clock position. He or she then pushes the skin clock-
wise around the face of the clock for one and one-quarter
circles, maintaining a constant pressure. The client’s
body is gently supported with the practitioner’s free
hand, which is placed opposite the hand making the cir-
cle. After each circular touch, the practitioner gently
slides the hand down the body and repeats the circle.

Benefits

Aura therapy is generally designed to bring imbal-
ances in the aura back into physical, mental, emotional,
and spiritual balance. The benefits can be subtle (like a
general feeling of peace and well-being) or dramatic
(like experiencing a spiritual transformation or feelings
of ecstasy). Changes may be immediate or can occur
over several days. Repeated therapy sessions can main-
tain and deepen the aura energy balance.

Persons who have received therapeutic touch or
Tellington touch from nurses frequently mention “com-
fort” or “humanizing of health care” as important benefits.

Therapeutic touch and Tellington touch appear to
benefit patients in intensive care units (ICUs), who fre-
quently develop mild psychiatric disturbances from being
isolated and from the fact that ICU equipment interferes
with normal human sensory perception. It is thought that
TT and Ttouch help to break down the patient's feelings
of isolation and disconnection from other people.

Description

Traditionally, an aura is a protective psychic and
spiritual energy field that surrounds the physical body.

165

Aura therapy

Energy from an aura is usually not static. It is constantly
flowing, flashing, vibrating, expanding, and decreasing.
The colors detected usually indicate emotions, such as:

• lavender and purple for spirituality

• red/orange for sexual passion

• white for truth

• rose or pink for love

• red for anger

• yellow for intellect

Slow, deep breaths expand the aura while fast, shallow
breaths decrease it. Spaces or gaps in the aura usually signi-
fy disease. These gaps often appear near the affected area,
such as around the heart to signify heart disease. In gener-
al, auras have seven levels. Physical and ethereal auras ex-
tend up to a foot from the body, imagination and emotional
auras extend about two feet, while the mental, archetypal
(destiny), and spiritual auras extend about three feet.

There seems to be a general consensus among aura
therapists that more than one session is required for opti-
mal balancing. Many suggest three sessions within two
or three weeks. The first session focuses on the physical
aura, the next on the emotional, and the third on the spir-
itual. Once the aura levels are in balance, follow-up ses-
sions are encouraged every six months to a year. Aura
therapy is not covered by medical insurance. The cost
can range from $50 to $100 or more per session.

Preparations

No advance preparation is required. However, many
aura readers and therapists say the patient should have a
genuine desire for better health and happiness. Also,
many therapists suggest patients abstain from recreation-
al drugs, alcohol, and sex for several days before the
therapy for a better sense of clarity and focus.

Precautions

There are no known precautions associated with
aura therapy.

Side effects

No negative side effects associated with aura thera-
py have been reported, although a small minority of pa-
tients treated with TT or Ttouch report feeling uncom-
fortable with being touched by strangers.

Research & general acceptance

Aura color therapy is considered a New Age treat-
ment and is not generally accepted as valid by the con-

166

ventional medical community. Skeptics argue that there
are no scientific studies documenting the benefits of aura
therapy or the existence of a human biofield. Most re-
ports of the benefits of aura color therapy are anecdotal
and appear in New Age journals and magazines.

Although therapeutic touch has become a popular
alternative/complementary approach in some schools of
nursing in the United States and Canada, acceptance by
the mainstream medical community varies. Many hospi-
tals permit nurses and staff to perform TT on patients at
no extra charge. On the other hand, however, therapeutic
touch became national news in April 1998 when an ele-
mentary-school student carried out research for a science
project that questioned its claims. Twenty-one TT practi-
tioners with experience ranging from one to 27 years
were blindfolded and asked to identify whether the in-
vestigator’s hand was closer to their right hand or their
left. Placement of the investigator's hand was determined
by flipping a coin. The TT practitioners were able to
identify the correct hand in only 123 (44%) of 280 trials,
a figure that could result from random chance alone. De-
bate about the merits of TT filled the editorial pages of
the Journal of the American Medical Association for
nearly a year after the news reports.

Tellington touch training is offered by some schools
of veterinary medicine in the United States, and as of
2003 is also offered in continuing education programs in
schools of nursing. It appears to be gaining wider sup-
port from the mainstream medical community as a useful
technique in calming patients facing unpleasant or
painful procedures. One study found that patients await-
ing venipuncture who received Ttouch were more re-
laxed before the procedure and had significantly less dis-
comfort afterward.

Training & certification

No formal training or certification is required to
practice aura reading, aura color therapy, TT, or Ttouch.
However, a number of alternative medicine and New
Age healing schools offer formal training and certifica-
tion. Therapeutic touch and Tellington touch have their
own training and certification programs.

Resources

BOOKS

Bain, Gabriel Hudson. Auras 101 : A Basic Study of Human
Auras and the Techniques to See Them. Flagstaff, AZ:
Light Technology Publications, 1998.

Bartlett, Sarah. Auras and How to See Them. London, UK:
Collins & Brown, 2000.

Chiazzari, Suzy. The Complete Book of Color: Using Color for
Lifestyle. Health, and Well-Being, Part Six: Healing
Through the Aura. Boston, MA: Element, 1998.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Astral — Of or from the stars.

Aura — An energy field that is thought to emanate
from the human body and to be visible to people
with special psychic or spiritual powers.

Biofield therapies — A subgroup of energy thera-
pies that make use of energy fields (biofields)
thought to exist within or emanate from the
human body. Biofield therapies include such ap-
proaches as aura therapy, Reiki, therapeutic touch,
qigong, and polarity balancing.

Bodywork — Any healing technique involving
hands-on massage or manipulation of the body.

Clairvoyant — A person who has the power to see
within their mind a future event or an event or
thing out of their visual range.

Ethereal — Something that is of or from the heav-
ens, usually used in a metaphysical sense.
Tellington touch (Ttouch) — A form of energy ther-
apy that combines aspects of the Feldenkrais
method of bodywork with aura therapy.
Therapeutic touch (TT) — An American form of en-
ergy therapy based on the ancient tradition of the
laying-on of hands. TT is thought to work by re-
moving energy blockages or disturbances from the
patient's aura.

Krieger, Dolores, Ph.D., R.N. Accepting Your Power to Heal:
The Personal Practice of Therapeutic Touch. New York:
Bear & Company, 1993.

MacFarlane, Muriel. Heal Your Aura: Finding True Love by
Generating A Positive Personal Energy Field. Secaucus,
NJ: Citadel Press, 1999.

Oslie, Pamela. Life Colors: What the Colors in Your Aura Re-
veal. Novato, CA: New World Library, 2000.

Snellgrove, Brian. The Magic in Your Hands: How to See Auras
and Use Them for Diagnosis and Healing. Essex, UK: C.
W. Daniel, 1998.

Tellington-Jones, Linda, and Sybil Taylor. The Tellington
Touch: A Breakthrough Technique to Train and Care for
Your Favorite Animal. New York and London, UK: Pen-
guin Books, 1995.

PERIODICALS

Demmer, C., and J. Sauer. “Assessing Complementary Therapy
Services in a Hospice Program.” American Journal of
Hospice and Palliative Care 19 (September-October
2002): 306-314.

Hewitt, J. “Psychoaffective Disorder in Intensive Care Units: A
Review.” Journal of Clinical Nursing 11 (September
2002): 575-584.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Rosa, Linda, MSN; Emily Rosa; Larry Sarner; and Stephen
Barrett, MD. “A Close Look at Therapeutic Touch.” Jour-
nal of the American Medical Association 279 (April 1,
1998): 1005-11.

“Somesthetic Aura: The Experience of Alice in Wonderland.”
The Lancet (June 27 , 1998): 1934.

Wendler, M. Cecilia. “Tellington Touch Before Venipuncture:
An Exploratory Descriptive Study.” Holistic Nursing
Practice 16 (July 2002): 51-64.

ORGANIZATIONS

Feldenkrais Guild of North America. 3611 S.W. Hood Avenue,
Suite 100, Portland, OR 97201. (800) 775-2118 or (503) 221-
6612. Fax: (503) 221-6616. <http://www.feldenkrais.com>.

International Society for the Study of Subtle Energies and En-
ergy Medicine (ISSSEEM). 356 Goldco Circle. Golden,
CO 80401. (303) 278-2228. <http://www.vitalenergy.
com/ISSS EEM.>.

National Center for Complementary and Alternative Medicine
(NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg,
MD 20898. (888) 644-6226. TTY: (866) 464-3615. Fax:
(866) 464-3616. <http://www.nccam.nih.gov.>.

The Nurse Healers Professional Associates International (NH-
PAI), the Official Organization of Therapeutic Touch. 3760
S. Highland Drive, Salt Lake City, UT 84106. (801) 273-
3399. nhpai@therapeutic-touch.org. <http://www.therapeu-
tic-touch.org.>.

TTEAM/Ttouch in USA. P. O. Box 3793, Santa Fe, NM 87506.
(800) 854-8326. <http://www.tellingtontouch.com>.

TTEAM/Ttouch in Canada. Rochdell Road, Vernon, BC V1B
3E8. (250) 545-2336. <http://www.tellingtontouch.com>.

OTHER

Auras website. The Healing Channel. <http://www.healing
channel.org/aura.html>.

Ken R. Wells
Rebecca J. Frey, PhD

Auriculotherapy

Definition

Auriculotherapy, also called ear acupuncture, ap-
plies the principles of acupuncture to specific points on
the ear. Auriculotherapists believe that healing processes
can be promoted by working with these points on the ear,
because the ear contains many blood vessels and nerve
endings that, when stimulated, influence the organs and
bodily functions.

Origins

Acupuncture is one of the world’s oldest therapeutic
techniques, having its roots in ancient China. Some of the

167

Auriculotherapy

oldest texts of Chinese medicine mention acupuncture
points and massage techniques specifically for the ear. For
eye problems, silver or gold earrings were sometimes pre-
scribed in ancient times to provide constant healing stimu-
lation at points on the ear, a practice that is still performed
in some areas of the world, including parts of Europe. The
ancient Egyptians and Greeks believed that working with
the ears could influence health. Hippocrates, the Greek fa-
ther of medicine, mentioned a point on the ear that could
be operated on as a birth control measure in men. In Eu-
rope in the Middle Ages, doctors prescribed surgery on a
particular spot on the ear for a condition called sciatica,
which causes nerve pain in the hips and thighs.

In modern times, auriculotherapy has been advanced
by Paul Nogier of France. Beginning his work and ex-
periments in the 1950s, Nogier laid out an intricate map
of points on the ear that correspond to the organs and
processes in the body. Nogier believed that the ear is
shaped like an upside down human fetus, and the
acupuncture points on the ear correspond to the body
parts of the fetus shape, with the earlobe representing the
head. Nogier theorized that by stimulating these points
on the ear, the corresponding organs and bodily process-
es would be stimulated by nerve impulses. Nogier also
theorized that by measuring electrical impulses on the
skin of the ear, problems could be detected in the internal
organs, and therefore auriculotherapy could be used to
diagnose illnesses. Nogier and many followers, includ-
ing ear acupuncturists in America and China, conducted
scientific experiments in auriculotherapy, and showed
some significant and surprising results in both treatment
and diagnosis of conditions. In 2002, a center in Maine
received a unique grant to study auriculotherapy for sub-
stance abuse. Although recognizing that acupuncture had
been used before for helping those with abuse, this study
sought to show that auriculotherapy ’s effects on relax-
ation response helped those abusing drugs and alcohol
better deal with the anxiety and life circumstances
thought to lead them to substance abuse.

Benefits

Auriculotherapy is a quick, inexpensive, and non-in-
vasive method of pain control. Ear acupuncture is also
used as anesthesia during medical procedures. It is used
frequently to help people overcome drug, tobacco, and
alcohol addictions, and is used to treat chronic health
conditions and diseases.

Description

After an initial exam and interview, auriculothera-
pists begin treatment by checking the patient’s ears
closely. Practitioners may palpate (feel) the ears with

168

their hands, and check for any irregularities or painful
spots. They may check for spots that are insensitive or
numb by using cold or hot needles on the ear. They may
also rely on electrical devices that measure skin resis-
tance at points on the ear.

Several techniques may be used during auriculother-
apy. Acupuncture needles are typically extremely thin.
More than one needle may be used at one time, inserted
deeply, or just pricked slightly along the contours of the
ear. On some points, needles may be twisted or slanted
to create more healing effects. Needles may be left in
from a few minutes to half an hour or more.

Auriculotherapists may use permanent press nee-
dles. These small, tack-shaped needles may be attached
to the ear with a narrow band of tape for several days or
weeks. They are used for conditions that may require
constant stimulation to acupuncture points on the ear,
such as addictions, chronic (long-lasting) infections, and
other health problems.

Auriculotherapists also practice electroacupuncture,
which utilizes electrical devices to send small electrical
currents into the ear or through the body. Electroacupunc-
ture is used for conditions such as paralysis or nerve dam-
age in the body, drug and alcohol addictions, and chronic
pain. Auriculotherapists may also employ bleeding, which
removes one or two drops of blood at certain points on the
ear. Bleeding is used for health problems such as high
blood pressure, high cholesterol, or heart disease.

Auriculotherapy is generally performed once per
week on patients for a sequence of several months, al-
though the frequency of treatment depends on the patient
and condition. Treatment may last for several months.
The initial visit to an acupuncturist is typically the most
expensive, costing from $80 to $200. Follow-up visits
are less expensive, from $50 to $100 on average. Auricu-
lotherapists may also prescribe herbal and nutritional
remedies. Insurance coverage of acupunture fees varies,
depending on individual policies.

Preparations

Before treatment, an auriculotherapist may perform
a thorough examination and interview the patient to de-
termine health conditions and any precautions or adjust-
ments that must be made. Acupuncturists often rely on
pulse diagnosis and other diagnostic techniques before
and during treatment.

For treatment, the patient should lie in a horizontal
position on a comfortable surface in a calm, stress-free
environment. After treatment, the patient should be per-
mitted to lie down until feeling capable of leaving the
practitioner’s office.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Acupuncture needles should be sterilized before use.
The ears should be disinfected before acupuncture as
well, which is usually done with a cotton ball dipped in
rubbing alcohol.

Precautions

Auriculotherapy, like all acupuncture, should not be
performed on weak or exhausted patients, nor on those
who are very hungry or have just eaten a meal or drunk
alcohol. Auriculotherapy should not be performed on
pregnant women during the first two trimesters (six
months) of pregnancy, and afterwards only on very par-
ticular points on the ear for pain control. Auriculotherapy
is not recommended for children under seven years old,
and should be performed with care on the elderly. Ear
acupuncture is to be avoided by those with anemia (low
red blood cell quantity in the blood). Patients with ner-
vous conditions should be thoroughly relaxed and pre-
pared before treatment. For people that find acupuncture
disagreeable, ear massage and acupressure may be
preferable to treatment with needles.

Side effects

Some patients may experience uncomfortable side
effects during or after acupuncture. Side effects that
may occur after treatment include fainting, dizziness,
nausea, numbness, headaches, sweating, or sharp pains
throughout the body. These reactions may be due to
anxiety or because acupuncture needles have been in-
serted too deeply or in the wrong area. Side effects can
be alleviated by removing the needles and allowing the
patient to lie down under supervision. Some side effects
that occur during treatment, such as hot flashes, in-
creased pulse, and temporarily increased symptoms, are
considered normal and usually disappear quickly.

Training & certification

The National Commission for Certification of
Acupuncturists (NCCA) conducts certification exams,
promotes national standards, and registers members.
Most states that license acupuncturists use the NCCA
standards as certification.

The American Association of Acupuncture and Ori-
ental Medicine (AAAOM) is the largest organization for
practitioners, with more than 1,600 members.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Anesthesia — Method of pain control during med-
ical procedures.

Chronic — Referring to illness or condition that is
long lasting.

Resources

BOOKS

Fleischman, Dr. Gary. Acupuncture : Everything You Ever
Wanted to Know. Barrytown, NY: Station Hill, 1998.

Hicks, Angela. Thorson’s Principles of Acupuncture. New
York: HarperCollins, 1997.

Requena, Yves, MD. Terrains and Pathology in Acupuncture.
Massachusetts: Paradigm, 1986.

PERIODICALS

American Journal of Acupuncture. 1840 41st Ave., Suite 102,
P.O. Box 610, Capitola, CA 95010.

Savage, Lorraine. “Grant to Study Acupuncture’s Effectiveness
on Patients Suffering from Substance Abuse." Healthcare
Review. (March 19, 2002): 16.

ORGANIZATIONS

American Academy of Medical Acupuncture. 5820 Wilshire
Blvd., Suite 500, Los Angeles, CA 90036, (213) 937-5514.

American Association of Acupuncture and Oriental Medicine.
433 Front St., Catasaugua, PA 18032, (610) 266-1433.

National Commission for Certification of Acupuncturists. 1424
16th St. NW, Suite 501, Washington, D.C. 20036, (202)
232-1404.

Douglas Dupler
Teresa G. Odle

Autism

Definition

Autism is a chronic and often severe disorder of
brain functioning that begins during childhood. It is
marked by problems with social contact, intelligence,
and language, coupled with ritualistic or compulsive be-
havior, sensory integration and processing problems, and
strange environmental responses.

Description

Autism is a lifelong disorder that interferes with the
ability to understand what is seen, heard, and touched.
This can cause profound problems in personal behavior

169

Autism

Autistic children sometimes respond to behavioral and educational treatments in schools such as this one in Salt Lake City,
Utah, that offers teachers specially trained to work with autistic children. (A/P Wide World Photos. Reproduced by permission.)

and in the ability to relate to others. A person with
autism must learn how to communicate normally and
how to relate to people, objects, and events. However,
not all patients suffer the same degree of impairment.
The severity of the condition varies between individuals,
ranging from the person with extremely unusual and ag-
gressive behavior to one with something resembling a
mild personality disorder or a learning disability.

Autism occurs in as many as one in 1 ,000 children,
and incidence is rapidly increasing. It is found three to
four times more often in boys than in girls. The condi-
tion occurs around the world in all races and all social
backgrounds. Autism usually is evident in the first three
years of life, although in some children it is difficult to
pinpoint when the problem actually takes hold. Often,
the condition may not be diagnosed until the child enters
school. A person with autism can have symptoms rang-
ing from mild to severe.

Two subgroups of autism have recently been ex-
plained by clinicians. Those with essential autism, as de-
fined by diagnostic tests, appear to have higher IQ scores
and fewer seizures than those with complex autism,
which offers a poorer outcome.

170

Causes & symptoms

Although the exact causes of autism are unknown,
many possibilities have been proposed. Most experts
believe that several independent factors contribute to
development of autism. The number and combinations
of these factors probably differ from person to person.
Research points to such precipitating conditions as fetal
alcohol syndrome, genetic connections (as with identi-
cal twins), brain stem defects, lead poisoning, a ner-
vous system defect, infections, food and inhalant aller-
gies, infant vaccination reactions, and digestive system
deficiencies.

Further studies point to major disturbances in the
body chemistry of children with autism. Disruption is
most often found in fatty acid metabolism, electrolyte
balances, problems with digestive functioning, pro-
duction of red and white blood cells, and the body’s
balance of minerals. Diseases that may trigger autistic
behavior include rubella in the pregnant mother,
tuberous sclerosis, candiasis infection, fragile X syn-
drome, encephalitis, cytomegalovirus (CMV), a se-
vere form of a herpes simplex infection, and untreated
phenylketonuria.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

There also appears to be a strong genetic basis for
autism. In October 2001, the National Institutes of
Health (NIH) reported that two regions of chromosomes
contain genes involved with autism, and that two other
chromosomes had a weaker relation to autism-related
genes. Genetically identical twins are much more likely
than fraternal twins to both have autism if one is affect-
ed. In a family with one autistic child, the chance of hav-
ing another child with autism is about one in 20, much
higher than in the normal population. Sometimes, rela-
tives of an autistic child have mild behaviors that look
very much like autism, such as repetitive behaviors and
social or communication problems. Research also has
found that some emotional disorders, such as manic de-
pression, occur more often in families of a child with
autism. At least one group of researchers has also found
a link between an abnormal gene and autism. The gene
may be just one of at least three to five genes that inter-
act in some way to cause the condition. Scientists sus-
pect that a faulty gene or genes might make a person vul-
nerable to develop autism in the presence of other fac-
tors, such as chemical imbalance, infection, or a lack of
oxygen at birth.

Autism affects the way in which the brain uses or
transmits information. Studies have found abnormalities
in several parts of the brains of those with autism that al-
most certainly occurred during fetal development. The
problem may be centered in the parts of the brain re-
sponsible for processing language and information from
the senses. Profound problems with social interactions
are the most common symptoms of autism. Infants with
the disorder will not cuddle, avoid eye contact, and in
general do not seem to like or require physical contact or
affection. Often, the child will not form attachments to
parents or the rest of the family. The child may not speak
at all, or speak very little and may show bizarre patterns
of speech, such as endlessly repeating words or phrases.
About 10% of those with autism have an exceptional
ability in particular areas, such as mathematics, memory,
art, or music.

Most autistic children appear to be mentally retard-
ed to at least some degree. Bizarre behavior patterns are
very common and may include repeated mimicking of
the actions of others, complex rituals, screaming fits,
rhythmic rocking, arm flapping, finger twiddling, and
crying without tears. Many of these children may react
to sounds by banging their head or flapping fingers.
Some less affected autistic adults who have written
books about their childhood experiences report that
sounds were often excruciatingly painful to them, forc-
ing them to withdraw from the environment or to try to
cope by withdrawing into their own invented world. A
common characteristic of individuals with autism is an

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

insistence on sameness. There may be strong reactions to
changes in food, clothing, and routines.

Diagnosis

Autism is diagnosed by obtaining a developmental
history of the child and observing and evaluating the
child’s behavior, communication skills, and social inter-
actions. Because the symptoms of autism are so varied,
the condition may go undiagnosed for some time. There
is no medical test for autism. The condition is often
missed, especially in mild cases or when additional hand-
icaps are present. Special screening tools help physicians
diagnose the condition. Medical tests are sometimes used
to rule out other possible causes of autistic symptoms.

Treatment

Early intervention proves critical in managing
autism. The American Academy of Pediatrics (AAP)
says that many parents have chosen alternative therapies
when more traditional therapies do not produce desired
results. Among therapies mentioned in the group's report
are nutritional supplements, elimination diets, immune
globulin therapy, and secretin (a hormone) therapy.

There is often a strong nutritional dysfunction in-
volved in autism. A major overhaul of the child’s diet
should be done, but very gradually. A healthy diet of
whole foods with no preservatives or additives, including
food dyes, is recommended. Autistic children may have
particular difficulty handling Nutrasweet and monosodi-
um glutamate (MSG), as these chemicals may further in-
terfere with already disrupted nerve impulses. Processed
foods such as white flour, white sugar, margarine, and
hydrogenated fats should be avoided because they inter-
fere with the stability of blood chemistry.

Many autistic children may be unable to effectively
break down the protein in grains such as wheat, barley,
and oats, called gluten, and the protein in milk called ca-
sein. Overgrowths of Candida albicans may be present
and should be tested for and treated. Testing should also
be done for food, chemical, and inhalant allergies. Di-
gestive functioning should be tested and monitored. Ex-
tensive testing should be done for blood levels of chemi-
cals in the body, as well. Allergens should be subse-
quently removed from the diet and environment; further
dietary changes should be made to correct chemical im-
balances. Possible gut and immune system dysfunction
should also be addressed.

Studies have shown that supplementation with mega-
doses of vitamin B 6 together with magnesium improves
eye contact, speech, and behavior problems. Vitamin B 6
causes fewer side effects than other medications, but

171

Autism

megadoses should only be given under the supervision of
a healthcare provider. A B-complex vitamin is probably
the best way to give B 6 , due to the interdependent func-
tioning of the B vitamins. Zinc and vitamin C supple-
mentation is also recommended. In addition, dimethyl-
glycine (DMG) has been reported to improve speech in
some children with autism in as little as a week’s time.
Other therapeutic methods that have been shown to be
helpful include special auditory integration training
(AIT) based on the Berard method or the Tomatis method.
Craniosacral therapy may also improve symptoms of
autism by relieving compressions of the skull bones and
membranes. Autism is a complex condition. A practitioner
who has already worked with cases of autism successfully
will be able to offer a comprehensive treatment plan.

Allopathic treatment

Most experts recommend a complex treatment regi-
men for autism that begins early in life and continues
through the teenage years. Behavioral therapies are used
in conjunction with medications and special diets. Be-
cause the symptoms vary so widely from one person to the
next, there is not a single approach that works best for
every person. Interventions include special training in
music, listening, vision, speech and language, and senses.
Sensory integration training may be used to normalize
sensory functions. Training to change aberrant behaviors
should be started as early in the autistic child’s life as pos-
sible, since early intervention appears to have the most in-
fluence on brain development and functioning. A child
with autism is able to learn best in a specialized, struc-
tured program that emphasizes individualized instruction.

No single medication has yet proved highly effec-
tive for the major features of autism. However, a variety
of drugs can control self-injurious, aggressive, and other
behaviors. Drugs also can control epilepsy, which af-
flicts up to 20% of people with autism. Types of recom-
mended medication may include stimulants, such as
methylphenidate (Ritalin); antidepressants, such as
fluroxamine (Luvox); opiate blockers, such as naltrexone
(Re Via); antipsychotics; and tranquilizers.

Expected results

Studies show that people with autism can improve
significantly with proper treatment. While there is no
cure, the negative behaviors of autism can be made to
improve. Earlier generations placed autistic children in
institutions; now, even severely disabled children can be
helped to eventually become more responsive to others.
Children with autism usually can learn to better under-
stand and deal with the world around them. Some can
even lead nearly mainstream lives.

172

KEY TERMS

Antidepressant — A type of medication that is used
to treat depression; it is also sometimes used to
treat autism.

Asperger syndrome — Children who have autistic
behavior but no problems with language.

Encephalitis — A rare inflammation of the brain
caused by a viral infection. It has been linked to
the development of autism.

Fragile X syndrome — A genetic condition related
to the X chromosome that affects mental, physical,
and sensory development.

Phenylketonuria (PKU) — An enzyme deficiency
present at birth that disrupts metabolism and caus-
es brain damage. This rare inherited defect may be
linked to the development of autism.

Rubella — Also known as German measles. When
a woman contracts rubella during pregnancy, her
developing infant may be damaged. One of the
problems that may result is autism.

Tuberous sclerosis — A genetic disease that causes
skin problems, seizures, and mental retardation. It
may be confused with autism.

Prevention

The mechanisms of autism are poorly understood.
There is currently no known method of prevention for
the condition. However, there is much debate as to what
part the measles, mumps, and rubella (MMR) vaccina-
tion and the diphtheria, pertussis, and tetanus (DPT)
vaccination may play in the onset of autism. A knowl-
edgeable alternative healthcare provider should be con-
sulted about the necessity of vaccination and possible al-
ternatives.

Resources

BOOKS

Barron, Sean, and Judy Barron. There’s a Boy in Here. New
York: Simon & Schuster, 1992.

Bratt, Berneen. No Time for Jello. Massachusetttes: Brookline
Books, 1989.

Cohen, Donald J., and Fred R. Volkmar. Handbook of Autism
and Pervasive Developmental Disorders. John Wiley &
Sons, 1997.

Cohen, Shirley. Targeting Autism: What We Know, Don't Know,
and Can Do to Help Young Children with Autism and Re-
lated Disorders. California: University of California
Press, 1998.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Hart, Charles. A Parent’s Guide to Autism: Answers to the Most
Common Questions. New York: Pocket Books, 1993.

PERIODICALS

Brunk D. “Three Tests Identify Two Autism Subgroups. (Two
Types Termed Essential and Complex).” Pediatric News
35, no. 12 (December 2001): 24.

“Could New Changes be on the Horizon for Managing
Autism?” The Brown University Child and Adolescent
Behavior Letter 17, no. 7 (July 2001): 1.

“Autism Genes Identified.” The Brown University Child and
Adolescent Behavior Letter 17, no. 10 (October 2001): 1.

Patience Paradox
Teresa G. Odle

Autoimmune arthritis see Ankylosing
spondylitis

Ayurvedic medicine

Definition

Ayurvedic medicine is a system of healing that origi-
nated in ancient India. In Sanskrit, ayur means life or liv-
ing, and veda means knowledge, so Ayurveda has been
defined as the “knowledge of living” or the “science of
longevity.” Ayurvedic medicine utilizes diet, detoxifica-
tion and purification techniques, herbal and mineral
remedies, yoga, breathing exercises, meditation, and
massage therapy as holistic healing methods. Ayurvedic
medicine is widely practiced in modern India and has
been steadily gaining followers in the West.

Origins

The three basic physiological principles or doshas.

Illustration by GGS Information Services, Inc. The Gale Group.

during the last two decades. Chopra is an M.D. who has
written several bestsellers based on Ayurvedic ideas. He
also helped develop the Center for Mind/Body Medicine
in La Jolla, California, a major Ayurvedic center that
trains physicians in Ayurvedic principles, produces
herbal remedies, and conducts research and documenta-
tion of its healing techniques.

Ayurvedic medicine originated in the early civiliza-
tions of India some 3,000-5,000 years ago. It is men-
tioned in the Vedas , the ancient religious and philosophi-
cal texts that are the oldest surviving literature in the
world, which makes Ayurvedic medicine the oldest sur-
viving healing system. According to the texts, Ayurveda
was conceived by enlightened wise men as a system of
living harmoniously and maintaining the body so that
mental and spiritual awareness could be possible. Med-
ical historians believe that Ayurvedic ideas were trans-
ported from ancient India to China and were instrumen-
tal in the development of Chinese medicine.

Today, Ayurvedic medicine is used by 80% of the
population in India. Aided by the efforts of Deepak
Chopra and the Maharishi, it has become an increasing-
ly accepted alternative medical treatment in America

Benefits

According to the original texts, the goal of Ayurveda
is prevention as well as promotion of the body’s own ca-
pacity for maintenance and balance. Ayurvedic treatment
is non-invasive and non-toxic, so it can be used safely as
an alternative therapy or alongside conventional therapies.
Ayurvedic physicians claim that their methods can also
help stress-related, metabolic, and chronic conditions.
Ayurveda has been used to treat acne, allergies, asthma,
anxiety, arthritis, chronic fatigue syndrome, colds, coli-
tis, constipation, depression, diabetes, flu, heart disease,
hypertension, immune problems, inflammation, insom-
nia, nervous disorders, obesity, skin problems, and ulcers.

Ayurvedic physicians seek to discover the roots of a
disease before it gets so advanced that more radical treat-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

173

Ayurvedic medicine

Ayurvedic physician uses a hot iron rod and fabric soaked
in herbs to heal an arthritic hip, Bhubaneswar, India. (©

Lindsay Hebberd/Corbis. Reproduced by permission.)

ments are necessary. Thus, Ayurveda seems to be limited
in treating severely advanced conditions, traumatic in-
juries, acute pain, and conditions and injuries requiring
invasive surgery. Ayurvedic techniques have also been
used alongside chemotherapy and surgery to assist pa-
tients in recovery and healing.

Description

Key ideas

To understand Ayurvedic treatment, it is necessary
to have an idea how the Ayurvedic system views the
body. The basic life force in the body is prana, which is
also found in the elements and is similar to the Chinese
notion of chi. As Swami Vishnudevananda, a yogi and
expert, put it, “Prana is in the air, but is not the oxygen,
nor any of its chemical constituents. It is in food, water,
and in the sunlight, yet it is not vitamin, heat, or light-

174

rays. Food, water, air, etc., are only the media through
which the prana is carried.”

In Ayurveda, there are five basic elements that contain
prana: earth, water, fire, air, and ether. These elements in-
teract and are further organized in the human body as
three main categories or basic physiological principles in
the body that govern all bodily functions known as the
doshas. The three doshas are vata, pitta, and kapha. Each
person has a unique blend of the three doshas, known as
the person’s prakriti, which is why Ayurvedic treatment is
always individualized. In Ayurveda, disease is viewed as a
state of imbalance in one or more of a person’s doshas,
and an Ayurvedic physician strives to adjust and balance
them, using a variety of techniques.

The vata dosha is associated with air and ether, and
in the body promotes movement and lightness. Vata peo-
ple are generally thin and light physically, dry-skinned,
and very energetic and mentally restless. When vata is
out of balance, there are often nervous problems, hyper-
activity, sleeplessness, lower back pains, and headaches.

Pitta is associated with fire and water. In the body, it is
responsible for metabolism and digestion. Pitta characteris-
tics are medium-built bodies, fair skin, strong digestion,
and good mental concentration. Pitta imbalances show up
as anger and aggression and stress-related conditions like
gastritis, ulcers, liver problems, and hypertension.

The kapha dosha is associated with water and earth.
People characterized as kapha are generally large or
heavy with more oily complexions. They tend to be slow,
calm, and peaceful. Kapha disorders manifest emotional-
ly as greed and possessiveness, and physically as obesity,
fatigue, bronchitis, and sinus problems.

Diagnosis

In Ayurvedic medicine, disease is always seen as an
imbalance in the dosha system, so the diagnostic process
strives to determine which doshas are underactive or over-
active in a body. Diagnosis is often taken over a course of
days in order for the Ayurvedic physician to most accu-
rately determine what parts of the body are being affected.
To diagnose problems. Ayurvedic physicians often use
long questionnaires and interviews to determine a person’s
dosha patterns and physical and psychological histories.
Ayurvedic physicians also intricately observe the pulse,
tongue, face, lips, eyes, and fingernails for abnormalities
or patterns that they believe can indicate deeper problems
in the internal systems. Some Ayurvedic physicians also
use laboratory tests to assist in diagnosis.

Treatment

Ayurvedic treatment seeks to re-establish balance and
harmony in the body’s systems. Usually the first method of

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

AYURVEDIC BODY TYPES

Vata

Pitta

Kapha

Physical characteristics

Thin

Average build

Large build

Prominent features

Fair, thin hair

Wavy, thick hair

Cool, dry skin

Warm, moist skin

Pale, cool, oily skin

Constipation

Ulcers, heartburn, and hemorrhoids

Obesity, allergies, and sinus
problems

Cramps

Acne

High cholesterol

Emotional characteristics

Moody

Intense

Relaxed

Vivacious

Quick tempered

Not easily angered

Imaginative

Intelligent

Affectionate

Enthusiastic

Loving

Tolerant

Intuitive

Articulate

Compassionate

Behavioral characteristics

Unscheduled sleep
and meal times

Orderly

Slow, graceful

Nervous disorders

Structured sleep and meal times

Long sleeper and slow eater

Anxiety

Perfectionist

Procrastination

treatment involves some sort of detoxification and cleans-
ing of the body, in the belief that accumulated toxins must
be removed before any other methods of treatment will be
effective. Methods of detoxification include therapeutic
vomiting, laxatives, medicated enemas, fasting, and
cleansing of the sinuses. Many Ayurvedic clinics combine
all of these cleansing methods into intensive sessions
known as panchakarma. Panchakarma can take several
days or even weeks and they are more than elimination
therapies. They also include herbalized oil massage and
herbalized heat treatments. After purification. Ayurvedic
physicians use herbal and mineral remedies to balance the
body as well. Ayurvedic medicine contains a vast knowl-
edge of the use of herbs for specific health problems.

Ayurvedic medicine also emphasizes how people
live their lives from day to day, believing that proper
lifestyles and routines accentuate balance, rest, diet, and
prevention. Ayurveda recommends yoga as a form of ex-
ercise to build strength and health, and also advises mas-
sage therapy and self-massage as ways of increasing cir-
culation and reducing stress. Yogic breathing techniques
and meditation are also part of a healthy Ayurvedic regi-
men, to reduce stress and improve mental energy.

Of all treatments, though, diet is one of the most basic
and widely used therapies in the Ayurvedic system. An
Ayurvedic diet can be a very well planned and individual-
ized regimen. According to Ayurveda, there are six basic

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

tastes: sweet, sour, salty, pungent, bitter, and astringent. Cer-
tain tastes and foods can either calm or aggravate a particular
dosha. For instance, sweet, sour, and salty decrease vata
problems and increase kapha. Sour, salty, and pungent can
increase pitta. After an Ayurvedic physician determines a
person’s dosha profile, he or she will recommend a specific
diet to correct imbalances and increase health. The
Ayurvedic diet emphasizes primarily vegetarian foods of
high quality and freshness, tailored to the season and time of
day. Cooling foods are eaten in the summer and heating ones
in the winter, always within a person’s dosha requirements.
In daily routine, the heaviest meal of the day should be
lunch, and dinner should be eaten well before bedtime, to
allow for complete digestion. Also, eating meals in a calm
manner with proper chewing and state of mind is important,
as is combining foods properly and avoiding overeating.

Cost

Costs of Ayurvedic treatments can vary, with initial con-
sultations running anywhere from $40 to over $100, with fol-
low-up visits costing less. Herbal treatments may cost from
$10 to $50 per month, and are often available from health
food or bulk herb stores. Some clinics offer panchakarma, the
intensive Ayurvedic detoxification treatment, which can in-
clude overnight stays for up to several weeks. The prices for
these programs can vary significantly, depending on the ser-
vices and length of stay. Insurance reimbursement may de-
pend on whether the primary physician is a licensed M.D.

175

Ayurvedic medicine

DEEPAK CHOPRA 1946-

(APAA/ide World Photos. Reproduced by permission.)

Deepak Chopra was born in India and studied medi-
cine at the All India Institute of Medical Science. He left
his home for the United States in 1970 and completed
residencies in internal medicine and endocrinology. He
went on to teaching posts at major medical institutions —

Tufts University and Boston University schools of medi-
cine — while establishing a very successful private prac-
tice. By the time he was thirty-five, Chopra had become
chief of staff at New England Memorial Hospital.

Disturbed by Western medicine's reliance on med-
ication, he began a search for alternatives and discovered
one in the teachings of the Maharishi Mahesh Yogi, an In-
dian spiritualist who had gained a cult following in the
late sixties teaching Transcendental Meditation (TM).
Chopra began practicing TM fervently and eventually met
the Maharishi. In 1 985 Chopra established the Ayurvedic
Health Center for Stress Management and Behavioral
Medicine in Lancaster, Massachusetts, where he began
his practice of integrating the best aspects of Eastern and
Western medicine.

In 1993, he published Creating Affluence: Wealth
Consciousness in the Field of All Possibilities , and the enor-
mously successful best seller, Ageless Body. Timeless Mind.
In the latter he presents his most radical thesis: that aging
is not the inevitable deterioration of organs and mind that
we have been traditionally taught to think of it as. It is a
process that can be influenced, slowed down, and even
reversed with the correct kinds of therapies, almost all of
which are self-administered or self-taught. He teaches
that applying a regimen of nutritional balance, medita-
tion, and emotional clarity characterized by such factors
as learning to easily and quickly express anger, for in-
stance, can lead to increased lifespans of up to 120 years.

Preparations

Ayurveda is a mind/body system of health that con-
tains some ideas foreign to the Western scientific model.
Those people considering Ayurveda should approach it
with an open mind and willingness to experiment. Also,
because Ayurveda is a whole-body system of healing and
health, patience and discipline are helpful, as some con-
ditions and diseases are believed to be brought on by
years of bad health habits and require time and effort to
correct. Finally, the Ayurvedic philosophy believes that
each person has the ability to heal themselves, so those
considering Ayurveda should be prepared to bring re-
sponsibility and participation into the treatment.

Precautions

An Ayurvedic practitioner should always be consult-
ed, particularly when using herbal preparations. Care
should be taken to ensure that a trained practitioner pre-
pares individualized remedies. In 2002, a New York City
hospital emergency department cautioned other hospitals

176

when they encountered a case of a patient who came in
with severe abdominal pain, occasional vomiting, and
eventually seizures. She had suffered severe lead toxicity
from an ayurvedic compound.

Side effects

During Ayurvedic detoxification programs, some
people report fatigue, muscle soreness, and general sick-
ness. Also, as Ayurveda seeks to release mental stresses
and psychological problems from the patient, some peo-
ple can experience mental disturbances and depression
during treatment, and psychological counseling may be
part of a sound program.

Research & general acceptance

Because Ayurveda had been outside the Western sci-
entific system for years, research in the United States is
new. Another difficulty in documentation arises because
Ayurvedic treatment is very individualized; two people
with the same disease but different dosha patterns might

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

be treated differently. Much more scientific research has
been conducted over the past several decades in India.
Much research in the United States is being supported by
the Maharishi Ayur-Ved organization, which studies the
Ayurvedic products it sells and its clinical practices.

In 2002, India took steps to make some of its most
important ayurvedic knowledge more widely available.
Many outside groups had begun to exploit the ancient
holistic practice’s remedies and companies were dupli-
cating processes and formulas, but calling them their
own. The Indian government appointed a task force in
January 2000 to promote and develop traditional medi-
cines and to prevent piracy of the country’s traditional
medical knowledge. The task force developed a digital
library with international and Indian languages describ-
ing about 35,000 ayurvedic herbal processes and formu-
lations to cure all kinds of diseases. The library became
available in early 2003 on the Internet.

Some Ayurvedic herbal mixtures have been proven
to have high antioxidant properties, much stronger than
vitamins A, C, and E, and some have also been shown in
laboratory tests to reduce or eliminate tumors in mice
and to inhibit cancer growth in human lung tumor cells.
In a 1987 study at MIT, an Ayurvedic herbal remedy was
shown to significantly reduce colon cancer in rats. An-
other study was performed in the Netherlands with Ma-
harishi Ayur-Ved products. A group of patients with
chronic illnesses, including asthma, chronic bronchitis,
hypertension, eczema, psoriasis, constipation, rheuma-
toid arthritis, headaches, and non-insulin dependent di-
abetes mellitus, were given Ayurvedic treatment. Strong
results were observed, with nearly 80% of the patients
improving and some chronic conditions being complete-
ly cured.

Other studies have shown that Ayurvedic therapies
can significantly lower cholesterol and blood pressure in
stress-related problems. Diabetes, acne, and allergies have
also been successfully treated with Ayurvedic remedies.
Ayurvedic products have been shown to increase short-
term memory and reduce headaches. Also, Ayurvedic
remedies have been used successfully to support the heal-
ing process of patients undergoing chemotherapy, as these
remedies have been demonstrated to increase immune sys-
tem activity. The herb gotu kola has been reported to re-
lieve anxiety and enhance memory.

Training & certification

In the United States, there is no standardized pro-
gram for the certification of Ayurvedic practitioners.
Many practitioners have primary degrees, either as
M.D.s, homeopaths, or naturopathic physicians, with ad-
ditional training in Ayurveda.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Dosha — One of three constitutional types, either
vata, pitta, or kapha, found in Ayurvedic medi-
cine.

Meditation — Technique of calming the mind.
Panchakarma — Intensive Ayurvedic cleansing and
detoxification program.

Prakriti — An individual's unique dosha pattern.
Prana — Basic life energy found in the elements.
Yoga — System of body and breathing exercises.

Resources

BOOKS

Gerson, Scott M.D. Ayurveda: The Ancient Indian Healing Art.
Boston: Element Books, 1993.

Lad, Dr. Vasant. Ayurveda: The Science of Self-Healing. Wis-
consin: Lotus Press, 1984.

Lad, Dr. Vasant. The Complete Book of Ayurvedic Home Reme-
dies. Minneapolis: Three Rivers Press, 1999.

Tiwari, Maya. Ayurveda: A Life of Balance. Vermont: Healing
Arts Press, 1995.

PERIODICALS

“India to Publish Ayurvedic Tracts on the Internet in Six Lan-
guages.” Nutraceuticals International (May 2002).

Mandile, Maria Noel. “Gotu Kola: This Ayurvedic Herb May
Reduce Your Anxiety Without the Side Effects of Drugs.”
Natural Health (May-June 2002): 34.

Traub SJ. et al. “85 Lead Toxicity Due to use of an Ayurvedic
Compound.” Journal of Toxicology : Clinical Toxicology
(April 2002): 322.

ORGANIZATIONS

American Institute of Vedic Studiess. P.O. Box 8357, Santa Fe,
NM 87504. (505) 983-9385.

Ayurveda Holistic Center. Bayville, Long Island, NY. (516) 759-
7731 mail@Ayurvedahc.com. <http://www.Ayurvedahc.
com>.

The Ayurvedic Institute. 11311 Menaul, NE Albuquerque, New
Mexico 87112. (505)291-9698. info@Ayurveda.com
<http://www.Ayurveda.com>

Ayurvedic and Naturopathic Medical Clinic. 10025 NE 4th
Street, Bellevue, WA 98004. (206) 453-8022.

Bastyr University of Natural Health Sciences. 144 N.E. 54th
Street, Seattle, WA 98105. (206) 523-9585.

Center for Mind/Body Medicine. P.O. Box 1048, La Jolla, CA
92038. (619) 794-2425.

The College of Maharishi Ayur-Ved, Maharishi International
University. 1000 4th Street, Fairfield, IA 52557. (515)
472-7000.

National Institute of Ayurvedic Medicine. (914)278-8700.
drgerson@erols.com. <http://www.niam.com>

177

Ayurvedic medicine

The Rocky Mountain Institute of Yoga and Ayurveda. RO. Box OTHER

1091, Boulder, CO 80306. (303)443-6923. “Inside Ayurveda: An Independent Journal of Ayurvedic Health

Care.” P.O. Box 3021, Quincy, CA 95971. <http://www.
insideayurveda.com.>

Douglas Dupler

178

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Bach flower remedies see Flower remedies
Back pain see Low back pain

Bad breath

Definition

Bad breath, also called halitosis, is an unpleasant
odor of the breath. Usually it is due to poor hygiene, but
it can be an indication of underlying health problems.

Description

Bad breath is likely to be experienced by most
adults and many children, at least occasionally. Some
people are strongly convinced that bad breath is present
when it is not. Bad breath can have a significant impact
on a person's social and professional life.

Causes & symptoms

Accumulation of plaque on the teeth is a major
cause of bad breath. Plaque is a mucus film that mixes
with food particles, saliva, and bacterial residue in the
mouth. Bad breath can also be caused by any number
of other problems. These include sores in the mouth,
infected tonsils, tooth or gum disease, fermentation of
food particles in the mouth, sinus infections, and
badly cleaned dentures. Conditions that may cause
bad breath are not only limited to the oral and nasal
areas. Other possible sources of the problem might be
indigestion, lung infection, kidney failure, tuberculo-
sis, syphilis, liver disease, stomach and intestinal
problems, stress, dehydration, zinc deficiency, and
cancer.

Cigarette smoking can also lead to bad breath, not
only in the smoker, but also in someone constantly ex-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

posed to secondhand smoke. A diet high in fats, spicy
foods, or one that includes coffee may contribute to un-
pleasant breath odors. Medications causing dry mouth
or dehydration may also be a source of problems, since
the flow of saliva helps clean out the mouth. Antihista-
mines, decongestants, antidepressants, anti-anxiety med-
ications, diuretics, and some heart medications may have
a dehydrating effect, and could be a cause of bad breath.

Diagnosis

The easiest way to determine if one has bad breath is
to ask a friend who is trustworthy and discrete, or to ask a
doctor or dentist. A test that can be attempted on one’s
own, is to cup a hand over the mouth, exhale, and then in-
hale through the nose while smelling the breath. A physi-
cal examination by a doctor or dentist may be used to di-
agnose other problems that may be causing the bad breath.

Treatment

Leaves of parsley, Petroselinum crispum; winter-
green, Gaultheria procumbens; or peppermint. Mentha
piperita; can be chewed to freshen the breath by the in-
troduction of their aromatic substances into the lungs. A
strong tea made of Echinacea spp.; myrrh, Commiphora
molmol; and bloodroot, Sanguinaria canadensis; can be
used as a daily mouthwash. Fresh apples, citrus fruits,
and celery are also good foods for helping to clean out
the mouth. Possible homeopathic remedies that may be
useful for bad breath include Nux vomica and Kali phos-
phoricum. Supplementing with zinc and vitamin C may
also be of benefit.

Allopathic treatment

The most effective treatment of bad breath is to treat
the cause. If bad breath is a continuing problem or there
are other symptoms, such as bleeding gums, a doctor or
dentist should be consulted. A medication change may
be warranted if a prescription drug is contributing to bad

179

Balm of Gilead

breath. A physician should be consulted any time a
change in medication is planned.

Expected results

Most bad breath can be treated successfully with
good oral hygiene or medical care. Occasionally, a per-
son may develop delusional or obsessive behavior re-
garding breath odor problems, and mental health coun-
seling may be appropriate.

Prevention

A healthy diet, high in fresh fruits and vegetables
and whole grains, should be eaten. Processed foods such
as sugar and white bread and grains contribute to plaque
formation and should be avoided. Spicy foods such as
onions, peppers, garlic, pastrami, salami, pepperoni, an-
chovies, and others should be avoided. Plenty of water
should be consumed throughout the day to avoid dehy-
dration and dry mouth. Water should be consumed after
taking any food or drink to wash away residues that may
accumulate with plaque.

The teeth should be brushed and flossed daily after
meals. Toothbrushes should be changed monthly, since
there may be a tendency for bacteria to accumulate on
them. Baking soda is a good choice to use for cleaning
the teeth when bad breath is a problem. The baking soda
makes the mouth pH less hospitable to odor-causing bac-
teria. Gentle brushing of the tongue should also be in-
cluded in the routine of daily oral hygiene, since the
tongue itself may harbor tiny particles of food. A device
called a tongue blade can be useful for cleaning the
tongue. It may be available from a store that sells Asian
or Middle Eastern products. An oral irrigation device,
such as a Water Pik, is recommended to more thoroughly
remove food and debris from the teeth. Mouthwashes are
often helpful, especially those containing zinc. A dentist
should regularly check the health of the gums and teeth
for disease. A dental hygienist should clean the teeth reg-
ularly, especially if there is an increased tendency to
form plaque.

Resources

PERIODICALS

Rosenberg, M. “Clinical Assessment of Bad Breath: Current

Concepts.” Journal of the American Dental Association

127 (April 1996): 475-482.

ORGANIZATIONS

American Dental Association. Box 776, St. Charles, IL 60174-

0776. http://www.ada.org.

Patience Paradox

180

Bai gou see Ginkgo biloba
Bai thu see Atractylodes (white)
Balding see Hair loss

Balm of Gilead

Description

Balm of Gilead ( Commiphora opobalsamum,
known as Populus candicans in the United States) is a
substance used in perfumes that is derived from the
resinous juices of the balsam poplar tree. The tree is a
member of the Bursera family. The variety that is native
to the continents of Africa and Asia is a small tree of
10-12 ft (3-3.6 m)in height. The cultivated North Ameri-
can variety can grow to heights of 100 ft (30 m).

The herb’s name derives from the ancient region of
Gilead in Palestine, known for the great healing powers
of its balm. Balm of Gilead is mentioned several times in
the Bible (e.g., Jeremiah 8:22). The writings of Pliny the
Elder indicate that the tree was brought to Rome in the
first century a.d. The historian Josephus recorded that
the Queen of Sheba made a gift of balm of Gilead to
King Solomon.

General use

In addition to being used in the composition of per-
fumes, balm of Gilead is used to soothe ailments of the
mucous membranes. It is taken internally to ease coughs
and respiratory infections. The balm is also said to re-
lieve laryngitis and sore throats. It can also be combined
with coltsfoot to make a cough suppressant.

Preparations

The resin of the balsam poplar tree is collected
when it seeps out of the tree during the summer months.
Seepage increases when humidity levels are high. Slits
may be made in the tree’s bark to collect the resin more
rapidly. The bark and leaf buds are also collected.

For the internal treatment of chest congestion, balm
of Gilead is made into a tincture or a syrup. To make a
syrup, the balm is combined with equal parts of elecam-
pane, wild cherry bark and one-half part of licorice
mixed with honey. The syrup can be taken by table-
spoons as needed.

For external treatment of bruises, swellings and
minor skin irritations, the balm is combined with lard or
oil and applied as needed. The bark, which contains

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Coltsfoot — A common weed, Russilago farfara,
used to treat chest complaints.

Elecampane — A perennial herb with large yellow
flowers used primarily as a digestive stimulant.
Resin — A sticky substance used for medicinal pur-
poses and in the manufacture of varnishes, ob-
tained from the bark of certain trees.

Salicylic acid — A crystalline substance that is the
active ingredient in aspirin.

traces of salicylic acid, can be combined with willow and
rosemary and used as a analgesic to relieve fevers, mus-
cle aches and arthritic pain.

Precautions

The sale and use of herbs as medicines, including
balm of Gilead, are not regulated by government
agencies. Therefore, consumers should exercise cau-
tion in purchasing and using herbs in this manner.
Consultation with a physician or pharmacist is always
recommended.

Side effects

In general, balm of Gilead is safe to use in small
amounts for coughs and other minor health problems.
Some people, however, may have allergic reactions to
the resin. In addition, patients with kidney and liver dis-
ease, as well as pregnant and nursing women, should
avoid the internal use of balm of Gilead.

Interactions

Balm of Gilead has no known interactions with stan-
dard pharmaceutical preparations.

Resources

BOOKS

Elias, Jason, and Shelagh Ryan Masline. Healing Herbal
Remedies. New York: Dell, 1995.

Tierra, Michael. The Way of Herbs. New York: Pocket Books,
1990.

OTHER

Grieve, M. “Balsam of Gilead.” (December 2000). <http://
www.botanical.com/ >

Mary McNulty

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Balneology see Hydrotherapy
Ban xia see Pinellia

Barberry

Description

Barberry, Latin name Berberis vulgaris, is native to
Europe, where it is commonly used as an ornamental
shrub. It is also commonly grown in North America. Its
close relative, Berberis aquifolium, is a native of North
America, and is also known as Oregon grape. Native
Americans originally taught settlers its value as a medic-
inal herb. Two other species of the plant, Nepalese and
Indian barberry, are native to those areas and possess
similar qualities.

Barberry is a perennial herb that is usually around 8
ft (2.4 m) tall, but can grow up to 10 ft (3 m) high. It
bears yellow flowers, red or black berries, and small
rounded fleshy leaves. It flourishes in dry sandy soil, and
prefers a sunny location. Research has established that
the active alkaloids in barberry belong to the isoquinoline
family. They are berberine, berbamine, oxyacanthine,
bervulcine, columbamine, isotetrandrine, jatrorrhizine,
magnoflorine, and vulvracine. Other components include
resin, tannin, and chelidonic acid, among others.

General use

Barberry and other berberine-containing plants have
been used throughout history for their medicinal proper-
ties. Chinese medicine has records of such use dating back
over 3,000 years. In addition to the fact that these plants
have been tried and tested over time, recent research has
indeed confirmed what herbalists have been teaching for
millennia — berberine has remarkable properties.

The berries of the barberry plant are traditionally
used to make jams and jellies, and the plant is used to
make a dye. However, its culinary use is only minor
compared to its importance as a member of the herbal
Materia Medica.

The medicinal actions of barberry are traditionally
classified as being cholagogue, hepatic, antiemetic, bitter
and laxative. Its main active constituent, berberine, has
recently been the subject of much research (it is the ac-
tive constituent of a number of valuable herbs, barberry
and goldenseal being two important examples), and has
been proven effective against a variety of ailments.

Barberry is chiefly valued as an efficient liver
cleanser, due to its ability to correct liver function and
promote the flow of bile. It is good for heartburn, stom-

181

Barberry

Barberry plant. (© PlantaPhile, Germany. Reproduced by permission.)

ach upsets, including gastritis, ulcers and ulcerative
bowel conditions, and is an effective appetite stimulant.
It has also been recommended for renal colic and the
treatment of renal calculi, where it is claimed to allay
burning and soreness.

The herb has significant antibacterial, antiviral
and antifungal properties, and has even demonstrated
antiprotozoal properties, so it is an extremely valuable
weapon against infection and fever. It is recommend-
ed for use against diarrhea, whether of non-specific
type, such as gastroenteritis, or from an identified
source such as cholera. It is also capable of inhibiting
the growth of Giardia lamblia, Trichomonas vagi-
nalis. and Entamoeba histolytica. In fact, barberry is
capable of similar action to Metronidazole, a common
antiprotozoal medication, but has the advantage of no
side effects.

Berberine, the active constituent of barberry, inhibits
Candida and other fungal growth, but does not affect
beneficial bacteria such as Acidophilus and Bifidus. Bar-
berry is particularly useful for skin infections, for which
it is often taken internally, and has even been found ef-
fective against psoriasis.

182

It is often used against bronchial infections, as it is
capable of breaking down and dispersing mucous accu-
mulations, and controlling further secretions. It is an ef-
fective sedative, is capable of lowering blood pressure,
and is an effective uterine stimulant. Barberry is also
taken for gallstones and inflammation of the gallbladder.
It has the ability to correct an enlarged spleen.

Barberry is useful for correcting menstrual irregu-
larities, correcting anemia, as a treatment for vaginitis,
and even as a tonic for a hangover. It is a suitable med-
ication for gouty constitutions. It is recommended for
strengthening the patient during convalescence, as it acts
as an immune stimulant.

Barberry can be used to treat malaria and even
Leishmaniasis, which is a protozoal infection. Nicholas
Culpeper praised the barberry plant highly, and stated
that the berries are just as useful as the bark. He recom-
mended their use for the cure of ringworm, in addition to
the ailments already mentioned.

Because it is capable of increasing blood supply,
barberry may be of use to those suffering from ventricu-
lar heart defects. Berberine is used in China to treat
white blood cell depression when caused by chemothera-
py or radiation treatments.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Preparations

The bark of the roots or stems are the parts used
medicinally.

The dried herb may be taken in a decoction, for
which place one teaspoonful of the herb in a cup of water
and bring to the boil. Leave for about fifteen minutes and
drink. This may be taken three time daily. The decoction
may also be used as a gargle in cases of sore throat.

If a tincture is being used, 1-2 ml may be taken three
times daily.

Herbalists recommend that in cases of gallbladder
disease, barberry combined with fringe tree bark and
black root are an effective treatment.

For an effective liver cleanse, herbalists recommend
a combination of one part barberry, one part wild yam,
one part dandelion, and one half part licorice root, sim-
mered in one pint of water for ten minutes, then strained
through a coffee filter.

The bark is sometimes made into a poultice for the
treatment of skin lesions, and a compress is useful for
swollen eye lids and conjunctivitis.

Precautions

Barberry root should not be taken by pregnant
women because of its stimulant effect on the uterus.
Those with heart disease or chronic respiratory prob-
lems should only take barberry after consultation with a
herbalist, naturopath, or medical specialist.

The cultivation of barberry is restricted in some areas,
as it hosts and promotes stem rust, a scourge to cereal crops.

If in any doubt, it is always best to consult a herbal
practitioner regarding dosage of herbs.

Side effects

Berberine (an active ingredient of barberry), has
been found to affect normal bilirubin in infants, so in
theory, it may have an adverse effect on jaundice.

Strong extracts may cause stomach upsets, so use of
barberry for a period of more than two consecutive
weeks is not recommended.

Barberry, if taken to excess may cause nose bleeds,
lethargy, kidney irritation, skin and eye inflammation, in
addition to headaches and low blood sugar.

Interactions

Barberry, or any herb containing berberine, has been
found to interact with Sumycin, Helidac (Tetrecycline),
Vibramycin, Helidac (Tetracycline), Doxycycline, and
Achromycin, causing them to be less effective, and to af-
fect their absorption.

KEY TERMS

Antiemetic — Prevents or alleviates nausea or 3

C/5

vomiting. “

Bitter — Reduces toxins, fights infection and fever,
and acts as a mild tonic.

Cholagogue — Stimulates the flow of bile from the
liver to the intestines.

Decoction — A strong infusion of a herb in water,
usually denoting that it is left to stand for longer
than an infusion.

Hepatic — Promotes the well being of the liver.

Leishmaniasis — A disease of the tropics transmit-
ted by sandflies.

Laxative — Promotes evacuation of the bowels.

Materia medica — A list of drugs or herbs used
medicinally.

Protozoa — Single-celled organisms, many of them
intestinal parasites.

Ventricular — Pertaining to the two lower cham-
bers of the heart.

Resources

BOOKS

Culpeper, Nicholas. Culpeper’ s Complete Herbal. London:
Bloomsbury Books, 1992.

Duke, James A. The Green Pharmacy. New York: St. Martin's
Paperbacks, 1998.

Grieve, M. A Modern Herbal. London: Tiger Books Interna-
tional, 1992.

OTHER

Hoffman, David L. "Barberry.” Healt World Online. <http://
www.healthy.net/asp.>

Birdsall, Timothy and Gregory Kelly. "Berberine: Theraputic
Potential of an Alkaloid found in several Medicinal plants.”
In Alternative Medicine Review [online database] Vol. 2,
no. 2 (March 1997). <http://www.thorne.com/altmed
rev/fulltext/berb.html.>

Patricia Skinner

Barley grass

Description

Barley grass is the leaf portion of the barley plant
( Hordeum vulgare) that remains after the seeds have

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

183

Barley

Barley grass

been removed. As a grass, it is also known as a distichon,
meaning that it grows in two separate ranks, or rows. The
rows of barley grass are parallel to the central axis, form-
ing a loose sheath over the stem, which is sometimes
called the culm. This stem is hollow and jointed, and the
seeds are ellipitical and furrowed. The barley plant, an
annual that requires reseeding each year, reaches a
height of up to 3 ft (about 1 m). The plant has an exten-
sive history in human and animal nutrition. As a nutri-
tional supplement, it is preferable to use young barley
plants that have not yet developed seeds.

General use

The barley plant appears to have been used by the
ancient Egyptians, Romans, and Vikings. It is believed
that Columbus brought it to the Americas in 1493. Bar-
ley seeds have been used in both human nutrition and
medicine. When the seeds are boiled, they release a thick
substance that soothes sore throats. Barley seeds are used
for the preparation of malt extract, which has a high
sugar content that makes it suitable as a flavoring agent
in pharmaceutical preparations.

Marketers make a number of claims regarding bar-
ley grass, including:

• It is the only vegetation on earth that can supply sole
nutritional support from birth to old age.

• Barley grass juice contains nutrients such as vitamins C
and E, which are much more potent together than when
taken separately.

• Barley grass is high in calcium, iron, all essential
amino acids, vitamin C, the flavonoids, vitamin B 12 ,
and a number of enzymes and minerals.

• Barley grass can be used to treat disorders of the stom-
ach and duodenum; pancreatitis; and as an anti-in-
flammatory agent.

• Barley grass contains superoxide dismutase (SOD), a
powerful antioxidant enzyme that protects the cells
against toxic free radicals.

Although not substantiated, one source has claimed
that barley grass is good for the following conditions:

• skin diseases

• hepatitis

• asthma

• anemia

• diabetes

• arthritis

• obesity

Barley grass contains vitamins, particularly B vita-
mins, as well minerals such as potassium, calcium, iron,

184

phosphorus, and magnesium. Enzymes contained in
the plant include SOD and nitrogen reductase. The latter
reduces nitrogen — an element commonly found in pro-
tein — in a biological process. Although barley grass con-
tains enzymes, the health benefits of these substances re-
main unclear. Enzymes are proteins, which are normally
broken down into their component chemicals during di-
gestion. However, the enzymes found in raw foods re-
main technologically unprotected from normal digestive
processes. The medical literature is not consistent on
whether any SOD is actually absorbed intact through the
digestive tract. In fact, the percentage absorbed may be
very small. Techniques are being developed to encapsu-
late enzymes into other molecules. This will allow the
enzymes to be absorbed intact, so that they will remain
active following digestion.

Barley grass and other cereal grasses may or may
not be useful sources of natural vitamins and minerals.
Evidence may be insufficient to justify claims that these
products improve physical health or cure disease. Barley
grass has not been reviewed by the United States Food
and Drug Administration (FDA) or the German Commis-
sion E. Nutrient concentration in barley grass products
varies with the conditions under which the plant is
grown. Like other natural supplements, commercial bar-
ley grass is not standardized; therefore, different crops
contain varying amounts of nutrients. Young barley grass
plants appear to contain higher concentrations of nutri-
ents than older plants.

One well-publicized Chinese study reported that
barley grass was beneficial in lowering cholesterol lev-
els in patients with type 2 diabetes. This may be due to
the plant’s antioxidant abilities. Similar results were
achieved by other researchers who studied the antioxi-
dant effects of red wine and tomato juice.

Other health claims made for barley grass remain
unconfirmed. For example, chlorophyll, the pigment
found in barley grass and all green plants, may have
some antibacterial effects. Chlorophyll reportedly in-
hibits the growth of cancer cells under laboratory condi-
tions, but its value in human health is unknown.

Similarly, the claim that barley grass can provide
full nutrition is subject to dispute. One researcher found
that people on a vegan diet that included barley grass
were likely to show reduced levels of vitamin B 12 , and to
require supplementation with this essential nutrient.

Preparations

Barley grass is available in capsule, powder, and
tablet formulations. Capsules are sold in strengths of 470
mg, 475 mg, and 500 mg. Tablets are available in 350
mg and 500 mg strengths.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Amino acid — An organic compound containing
an amino group (NH 2 ), a carboxylic acid group
(COOH), and various side groups. Amino acids
are bound together to form proteins.

Diabetes type 2 — A form of diabetes mellitus that
usually occurs in adults. The pancreas produces
insulin, but the muscle cells are resistant to the ef-
fects of the insulin. This was formerly called matu-
rity (or adult) onset diabetes.

Enzyme — A protein, produced by a living organ-
ism, that functions as an organic catalyst (a chemi-
cal that increases the speed of a reaction without
being involved in the reaction itself).

Vitamin — Any of various organic carbon-contain-
ing substances that are essential in minute
amounts for normal growth and activity of the
body, and are obtained naturally from plant and
animal foods.

Precautions

Barley grass may sometimes be rich in vitamin K,
which interferes with the action of anticoagulants such
as Coumadin (the brand name for warfarin, a drug used
to treat and prevent blood clots). Other than an allergic
reaction, there are no known adverse effects attributed to
barley grass.

Side effects

There are no known side effects attributed to barley
grass.

Interactions

No drug interactions have been associated with bar-
ley grass, with the exception of samples that are high in
vitamin K (interferes with Coumidin).

Resources

BOOKS

Lust J. The Herb Book. New York, NY: Bantam Books, 1984.
Reynolds J., ed. Martindale The Extra Pharmacopoeia. 30th
ed. London: The Pharmaceutical Press, 1993.

Seibold, R. Cereal Grass, Nature’s Greatest Health Gift. New
Canaan, CT: Keats Publishing Inc., 1991.

PERIODICALS

Donaldson, M.S. “Metabolic Vitamin B 12 Status on a Mostly
Raw Vegan Diet with Follow-up Using Tablets, Nutrition-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

al Yeast, or Probiotic Supplements.” Annals of Nutrition
and Metabolism 44 (2000): 229-34.

Gowri, J. W.. M. S. Turner, J. Nichols, et al. “Lipoprotein Oxi-
dation for Individuals with Type 2 Diabetes Mellitus.”
Journal of the American Colleee of Nutrition 18 (October
1999): 451-61.

Yu, Y. M„ Chang, W. C., Chang, C. T„ et al. "Effects of Young
Barley Leaf Extract and Antioxidative Vitamins on LDL
Oxidation and Free Radical Scavenging Activities in Type
2 Diabetes.” Diabetes Metab. (April 28, 2002): 107-14.

OTHER

Alberta Barley Commission. #200, 3601A - 21 Street N.E. Cal-
gary, Alberta T2E 6T5 CANADA. (403) 291-9111. (800)
265-9111. Fax: (403) 291-0190. <http://www.

albert abarley. com/kids/about . shtml> .

Green Green Grass.com. 7925-A N Oracle Rd #281 Tucson,
AZ 85704. (888) 773-9808. info@greengreengrass.com.
<http://www.greengreengrass.com/barleygreen_premium.
html>.

Herbal Information Center. 3507 Marsala Ct. Punta Gorda, FL
33950 <http://www.kcweb.com/herb/barley.htm>.

Samuel Uretsky, Pharm.D.

Bates method

Definition

The Bates method, popularized in the early twenti-
eth century by ophthalmologist William Horatio Bates,
involves the use of therapeutic eye exercises. Bates
claims these exercises will correct vision problems, thus
alleviating the need for glasses or contact lenses. Patients
practice eye exercises aimed at strengthening and train-
ing their eye muscles in an effort to overcome such prob-
lems as farsightedness (hyperopia), nearsightedness
(myopia), and astigmatism.

Origins

The method was devised by Bates, who was born in
1860 in Newark, New Jersey. In 1885. he received his
medical degree and began practicing in New York City.
Over the years, he began to notice that eye conditions
like myopia, which is caused by a refractive error, could
become better or worse for no apparent reason. Based on
this observation, he began to question a basic tenet of
traditional ophthalmology, which held that once a person
had a refractive error like myopia, the only way to cor-
rect it was by wearing glasses.

While traditional ophthalmologists believed that the
lens was responsible for the eye’s focus. Bates main-

185

Bates method

tained that it was the muscles around the eye that caused
the eye to focus. Thus, traditional ophthalmologists
blamed problems like nearsightedness on a failure of the
lens to properly focus, while Bates believed it was due to
a dysfunction of the muscles surrounding the eyeball.
Bates had come to this conclusion after performing eye
surgery on cataract patients and finding that some of
them could still see distance without glasses even though
he had removed the lens from their eyes; therefore, he
determined that the lens did not play a role in refractive
errors such as myopia.

At this point. Bates broke from his counterparts and
began focusing his attention on the muscles surrounding
the eye. He came to view eye problems as a result of
poor evolution, believing that the eye had not kept up
with human progress and had not evolved to allow read-
ing. He also blamed problems on artificial light, which
kept the eyes working longer hours each day than they
were intended to. Bates developed a series of eye exer-
cises to retrain the optic muscles to solve this evolution-
ary glitch.

Bates believed that eye strain caused vision to dete-
riorate, and his treatment was simple: like any other
muscles, the eye muscles need periods of rest and exer-
cise in order to achieve optimal performance. He focused
on the functioning of the six small muscles that control
the eye’s shape. When they become tense, they gradually
grow weak and result in nearsightedness, farsightedness,
astigmatism, or “lazy eye.”

The Bates method received acclaim several years
after Bates’s death (1931), when author Aldous Huxley
boasted that after two months on the Bates program, he
went from being almost blind to being able to read with-
out wearing glasses.

Benefits

An advantage of the Bates method is that the treat-
ment is relaxing. Also, if patients stick to the routine and
eye improvement is gained, they may benefit by being able
to discard their corrective lenses, escaping a lifetime of
costs for glasses, lenses, and contact solutions. The treat-
ment is also much less invasive than refractive surgery,
which is costly and has risks, just like any other operation.

Description

The Bates method maintains that vision problems
are caused by physiological and psychological strains
and therefore cannot be corrected by wearing glasses. He
believed that a combination of rest and exercise would
mend the eyes and devised several exercises aimed at
strengthening and retraining the eye muscles.

186

The exercises themselves are simple, but Bates
stressed that it takes discipline and attention to detail in
order to achieve improvement. Some of the principal ex-
ercises of the Bates method are described below.

Palming

Palming is aimed at calming the visual system. In
this exercise, patients close their eyes and cover them
with the palms of their hands, allowing the fingers to
cross on the forehead. The hands should be cupped so
that no pressure is put on the eyeballs. Next, the patient
should open his or her eyes and see if any light is getting
in. If so, the hands should be moved so that no light en-
ters and then close the eyes again. The warmth of a per-
son’s hands, combined with blocking out all light, will
relax a pair of tense eyeballs.

Sitting at a table is a good palming position. A per-
son can place a cushion on the table on which to rest
their arms, and should check the height to be sure their
hands are not too high or too low. Lying on the back,
with knees raised and feet flat on the floor, is also a good
position. While palming, patients should imagine a re-
laxing scene, such as a sunrise or ocean.

A description of the exercise posted on the Bates As-
sociation for Vision Education website suggests palming
in 5- 10-minute sessions, at least once a day. If this is
found unpleasant, a person can try mini-sessions, palm-
ing for a period of 15 breaths, up to 20 times a day. Palm-
ing may also help when the eyes become tired and bleary.

Swinging

Swinging is meant to train the eyes not to stare.
Bates maintained that the rigidity of staring was bad for
the eyes. To do this exercise, the patient should focus on
a fixed object, then swing the head or the entire body
from side to side while keeping the object in view by
moving the head instead of the eyes.

Test-card practice

Based on the idea that practice makes perfect, this
exercise involves practicing eye charts. Patients are
asked to focus on a letter, then close their eyes and visu-
alize the black letter for several seconds. After several
sessions. Bates maintains, the letters will appear blacker
and clearer.

Sunning

Sunning is aimed at reducing light sensitivity. Bates be-
lieved the sun has a therapeutic effect, so patients are asked
to close their eyes and face the sun. It is advised to sun only
in the morning or evening and only for short periods of time.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Centralization

Centralization, or central fixation, is aimed at
training the eye not to overstrain itself by taking in too
much at once. This exercise involves training the eyes
to focus on a single point, rather than an entire pic-
ture. The eye has a point in the middle of the vision
field where vision is sharpest. This exercise is aimed
at training people to look only at that point. Patients
are asked to look at an object piece by piece instead of
trying to look at it in its entirety, which Bates main-
tains is beyond the physical capabilities of the eye.
Bates believed that looking at an entire picture created
strain, causing bad eyesight. This is not an exercise
per se, but rather something patients are asked to do
all day long.

Color days

This involves spending the day focused on looking
for a specific color. When looking at a color, patients are
asked to focus on the color, not the form. Colors change
every day.

People interested in the Bates method can pay a pro-
fessional trained in the method to teach them the exercis-
es or they can simply read about them in books or on the
internet for no cost. Bates believed that improvement
would vary, depending on the degree of problem and a
person’s devotion to doing the exercises.

Preparations

There are no pre-therapy procedures.

Precautions

People should be aware that the theory remains un-
proven. This method should not be a substitute for ap-
propriate medical treatment in the case of cataracts,
glaucoma, and other eye diseases.

Side effects

There are no side effects, but patients should be cau-
tious when using the sunning exercise, which may cause
solar retinitis, or inflammation of the retina, causing per-
manent damage.

Research & general acceptance

Though the Bates method was devised a century
ago, it has never been tested in a clinical setting. At best,
anecdotal evidence is all there is to substantiate its use.

The orthodox ophthalmologists of Bates’s time, as
well as those of today, have largely dismissed his theo-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Astigmatism — An eye condition that causes a per-
son to see distorted images due to an abnormality
in the curvature of the eye's lens.

Farsightedness — Being able to see more clearly
those objects far away as opposed to those that
are near. Also called hyperopic.

Nearsightedness — Being able to see more clearly
those objects that are near as opposed to those in
the distance. Also called myopia.

lies as based on flawed science. Traditional ophthalmol-
ogists hold that the lens — not the eye muscles — is re-
sponsible for focus and therefore cannot be fixed
through a series of exercises. Traditional ophthalmolo-
gists believe that problems like nearsightedness are
anatomic conditions that cannot be fixed by strengthen-
ing the eye muscles.

As Philip Pollack noted in his book The Truth About
Eye Exercises, Bates used testimonials and case histories
depicting successful treatment as scientific proof his the-
ory was sound. Pollack also lambasted Bates for describ-
ing rare cases as the norm, using them as justification for
his methods.

The Bates method has not found widespread use
and is generally not accepted by the medical establish-
ment. In his book Health Education Authority Guide to
Complementary Medicine and Therapies, A. Woodham
cautions that the medical consensus is that “eye exer-
cises can improve the sight in some cases, but these
need a lot of dedication and perseverance. Do not ex-
pect miracles.”

Training & certification

Natural vision improvement techniques, such as the
Bates method, are generally taught by behavioral op-
tometrists or vision therapists. Vision therapists may not
necessarily be trained in optometry. It is possible, how-
ever, to find practicing optometrists trained by the Bates
Association for Vision Education, which offers courses
on the method.

Resources

BOOKS

Bates, W. The Bates Method for Better Eyesight without Glass-
es. New York: Henry Holt & Co., 1987.

Cheney, E. The Eyes Have It: A Self-Help Manual for Better

Vision. York Beach, Maine: Samuel Weiser, Inc., 1987.

187

Bates method

Bayberry

PERIODICALS

Booth, Brian. “Nature Cures: Hydrotherapy, Bates Method."

Nursing Times 91 no. 20 (May 1995): 42-43.

Karatz, May Annexton. “William Horatio Bates, M.D., and the
Bates Method of Eye Exercises.” New York State Journal
of Medicine 75 no. 7 (June 1975): 1105-1110.

ORGANIZATIONS

College of Optometries in Vision Development. P.O. Box 285,
Chula Vista, CA 91912. (619) 425-6191. Fax: (619) 425-0733.

OTHER

“Bates Method.” The Vision Improvement Site. 16 July
2000. <http://lightning.prohosting.com/-hanwen/vision/
bates.htmx

“Fallacies of the Bates System.” 14 July 2000.

Quackwatch.com. <http:// www.quackwatch.com>.

“Who Was Dr. Bates?” Bates Association for Vision Education.
<http://www.seeing.org/intro/faq/faq01.htm>. 14 July 2000.

Lisa Frick

Bayberry

Description

Bayberry, also known as wax myrtle, waxberry, or
candelberry, is both a shrub and a tree. All members of
the bayberry family are classified botanically as Myri-
caceae, and many varieties are found all over the world,
including Japan, South America, the West indies, the
United Kingdom, and in the United States.

American bayberry ( Myrica cerifera ) is a shrub that
grows 3-8 ft (1-2.4 m) high. It is found in eastern North
America, in marshes and bogs near sandy Atlantic
coastal areas, as well as in similar areas along the shores
of the Great Lakes. American bayberry is the variety
most often mentioned by herbalists.

American bayberry and its British Isles cousin, Eng-
lish bog myrtle, are very alike in appearance, and grows
to a similar height. Foliage is evergreen and consists of
knife -blade shaped shiny leaves that have small spots on
them. When crumpled in one’s hand, bayberry leaves
and its bark produce a pleasant, balsamic aroma. Howev-
er, they have a very bitter, astringent taste. The small
berries are in globular clusters at stem junctions, crusted
with a greenish-white waxy substance sprinkled with
small black flecks. The exterior of bayberry root bark is
mottled, with smooth reddish-brown cork underneath.

General use

Both American bayberry and English bog myrtle,
besides sharing a similar appearance, have similar medi-

188

cinal qualities. Like all bayberry varieties, they are clas-
sified as astringent herbs. Some evidence suggests that
these herbs have antimicrobial capabilities, in that they
are able to prevent the development of pathogenic activi-
ty from microbes, and are useful in regulating mucus in
the body.

Both varieties’ bark and roots contain starch, lignin,
gum, albumen, tannic and gallic acids, astringent resin, a
red coloring substance, a vaporous oil, and an acid simi-
lar to saponin. Powdered bayberry root is useful as a
bowel astringent in the treatment of diarrhea and colitis,
a soothing and helpful gargle for the common cold or a
sore throat, and as a douche in the treatment of leukor-
rhea, an abnormal white or yellow mucoid discharge
from the vagina or cervix. In the Herbal Materia
Medica, bayberry root bark is classified as an astringent,
a circulatory stimulant, as well as a diaphoretic, a reme-
dy which dilates superficial capillaries and induces per-
spiration, sometimes used to reduce fevers.

The berries of both American bayberry and English
bog myrtle, when boiled in water, produce myrtle wax,
which is composed of stearic, palmitic, myristic, and
oleaic acids. This is used in making bayberry-scented
soaps and bayberry candles, which are fragrant, more
brittle than bees’ wax candles, and are virtually smoke-
less. Four pounds of berries produce approximately one
pound of wax. A briskly stimulating shaving cream was
also made from this bayberry wax.

The wax’s modern medicinal uses were first discov-
ered and came into use in 1722, and included the mak-
ing of surgeon’s soap plasters. The water that the berries
were boiled in during wax extraction, when boiled down
to an extract, has been used in the North Country of
England and Scotland for centuries as a treatment for
dysentery. Narcotic properties are also attributed to bay-
berry wax.

In A Modern Herbal, that the leaves of English bog
myrtle were commonly used in France to induce both
menstruation and abortion.

In China, bayberry leaves are infused to make a tea
which is used both to relieve stomach problems, and as a
cordial, which is a stimulating medicine or drink.

A mouthwash particularly useful in inhibiting halli-
tosis can be made from either the powdered root or
leaves.

Bayberry bark has traditionally been used to tan
leather and dye wool.

Bayberry branches have been used in lieu of hops in
the fermentation of gale beer , popular in northern Eng-
land, and reported to have more than the usual “thirst-
quenching” ability.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Bayberries. (Photo Researchers, Inc. Reproduced by permission.)

Bayberries can be ground to use as spice, or added
to broths.

In the West Indies, Pimento acris, commonly called
wild cinnamon or bayberry, is used in making both bay
rum and oil of bayberry.

M. pennsylvanica’ s root can be used to induce vom-
iting.

The Brazilian species, Tabocas combicurdo , is de-
scribed in A Modem Herbal as a “pick-me-up.”

Preparations

Bayberry preparations are made by collecting root
bark in late fall or early winter, drying thoroughly, and
either pulvarizing into a powder or chopping the bark. It
should be stored in a tightly sealed containers, away
from light.

A decoction or tea is prepared by adding a teaspoon-
ful of powdered bayberry bark to a cup of cold water and
bringing this to a boil. If using chopped, not powdered,
bark, the decoction is simmered. This tea is then left to
steep for 15-20 minutes before drinking. It may be taken
up to three times a day for a limited period of time, as

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

chronic use at this dosage could damage a person’s kid-
neys and liver. The same preparation can be used as a
gargle for sore throat.

Tincture of bayberry preparations are also available in
some locales. Usual dosage is one-half teaspoonful in water.

Precautions

As noted previously, English bog myrtle has histori-
cally been shown as having characteristics capable of in-
ducing abortion. Its leaves, in nature, also have a poiso-
nous, volatile oil present, which can be removed by boil-
ing. Though no studies were found indicating the same
capabilities for American bayberry, because of their
many similarities, it should be assumed that neither Eng-
lish bog myrtle nor American bayberry leaves should be
ingested in their natural, unprepared state. Additionally,
aforementioned dosages of a bayberry decoction or tea
should not be taken on a chronic basis, as damage to the
kidneys and liver could occur.

Side effects

Powdered bayberry root, if inhaled, can cause con-
vulsive episodes of both sneezing and coughing.

189

Bayberry

Bedsores

Several varieties of the bayberry family are used as
emetics, which are agents used to induce vomiting, and
can also cause nausea.

Interactions

To date, no reported interactions with either food,
drug, or other herbal preparations have been found.

Resources

BOOKS

Grieve, M. and C.F. Leyel Barnes. A Modern Herbal: The
Medical, Culinary, Cosmetic and Economic Properties,
Cultivation and Folklore of Herbs, Grasses, Fungi, Shrubs
and Trees With All of Their Modern Scientific Uses.
Bames and Noble Publishing, 1992.

Hoffman, David and Linda Quayle. The Complete Illustrated
Herbal: A Safe and Practical Guide to Making and Using
Herbal Remedies. Bames and Noble Publishing, 1999.
Thayer, Henry. Fluid and Solid Extracts. Geo.C. Rand &
Avery, 1866.

Joan Schonbeck

Bearberry see Uva ursi
Beard moss see Usnea

Bedsores

Definition

Bedsores are the result of inflammation and damage
caused by irritation to the skin and inhibited blood flow.
The condition occurs when skin is rubbed against a bed,
chair, cast, or other hard object for an extended period of
time. Bedsores can range from mild inflammation to
deep wounds that involve muscle and bone. Infections
can be a serious complication to the condition.

Description

Bedsores are also called decubitus ulcers, pressure
ulcers, or pressure sores. They often start out with shiny
red skin that becomes itchy or painful, then quickly blis-
ters and deteriorates into open sores. Once there is a
break in the skin, there is a strong possibility of the sore
becoming infected, causing further medical problems.
Bedsores are most apt to develop over the bony promi-
nences of the ankles, the hip bones, the lower back, the
shoulders, the spinal column, the buttocks, and the heels
of the feet. Bedsores are most likely to occur in people
who must use wheelchairs or who are confined to bed.

190

Bedsores are medically categorized by stages:

• Stage I: The skin reddens, but it remains unbroken.

• Stage II: Redness, swelling, and blisters develop. There
is possibly peeling of the outer layer of the skin.

• Stage III: A shallow open wound develops on the skin.

• Stage IV: The sore deepens, spreading through layers
of skin and fat down to muscle tissue.

• Stage V: Muscle tissue is broken down.

• Stage VI: The underlying bone is exposed, and there is
danger of severe damage and infection.

Causes & symptoms

Bedsores most often happen when the most superfi-
cial blood vessels are pressed against the skin and
squeezed shut, closing off the flow of blood. If the sup-
ply of blood to an area of skin is cut off for more than an
hour, the tissue will began to die due to lack of oxygen
and nutrients. Ordinarily, the layer of fat under the bony
areas of the skin helps keep the blood vessels from being
compressed in this way. Also, people have a normal im-
pulse to change positions frequently when they are sit-
ting or lying down, so the blood supply is usually not
kept from any area of the skin for very long. Bedsores
are most likely to occur in people who have lost the pro-
tective fat layer or whose movement impulse is hindered.

Friction or rubbing from poorly fitted shoes or
clothing and wrinkled bedding often cause a sore to de-
velop. Constant exposure to the moisture of urine, feces,
and perspiration may also cause the skin to deteriorate.
In such cases there is an increased the risk of skin infec-
tion as well as sores.

Risk factors for bedsores:

• older than 60 years of age

• heart disease

• diabetes

• diminished tactile sensation

• incontinence

• malnutrition

• obesity

• paralysis or immobility

• poor circulation

• prolonged bed rest

• spinal cord injury

• anemia

• disuse atrophy

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Diagnosis

Physical examination of the skin, medical history,
and patient and caregiver observations are the basis of
diagnosis. Any sign of reddening of the skin will be
closely monitored.

Treatment

Contrasting hot and cold local applications can increase
circulation to problem areas and help flush out waste prod-
ucts, speeding the healing process. Hot compresses should
be applied for three minutes, followed by 30 seconds of cold
compress application, repeating the cycle three times. The
cycle should always end with the cold compress. In addition,
zinc and vitamins A, C, E, and B-complex should be taken
to help maintain healthy skin and repair injuries.

Herbal remedies

A poultice can be made of equal parts of powdered
slippery elm, Ulmus fulva: marsh mallow root. Althaea
officinalis ; and Echinacea spp. The herbs should be
blended together with a small amount of hot water and
applied to the skin three or four times per day to relieve
inflammation. Poultices used on broken skin or infected
areas should never be reused.

An infection-fighting rinse can be made by diluting
two drops of essential tea tree oil, Melaleuca spp., in
eight ounces of water. This should be used to bathe the
wound when bandages are changed.

An herbal tea made from Calendula officinalis can
be used as an antiseptic wash and a wound healing agent.
Calendula cream can also be applied to the affected area.

A poultice made from goldenseal, Hydrastis
canadensis, and water or goldenseal ointment can be ap-
plied to areas of inflammation several times per day to
heal the skin and prevent infection.

Allopathic treatment

A healthcare provider should be consulted whenever
a person develops bedsores. An emergency situation may
be indicated if sores become tender, swollen, or warm to
the touch, if the patient develops a fever, or if the sore
has pus or a foul-smelling discharge.

For mild bedsores, treatment basically involves re-
lieving pressure on the area and keeping the skin clean
and dry. When the skin is broken, a non-stick covering
may be used. A saline solution is often used to clean the
wound site whenever a fresh bandage is applied. Disin-
fectants are applied if the site is infected. The doctor may
also prescribe antibiotics, special dressings or drying
agents, and ointments to be applied to the wound. Heat

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

A Bedsore. (Photograph by Michael English, M.D., Custom
Medical Stock Photo. Reproduced by permission.)

lamps are used quite successfully to dry out and heal the
sores. Warm whirlpool treatments are sometimes also rec-
ommended for sores on the arm, hand, foot, or leg.

In a procedure called debridement, a scalpel may be
used to remove dead tissue or other debris from the wound.
Deep sores that don’t respond to other therapy may require
skin grafts or plastic surgery. If there is a major infection,
oral antibiotics may be given. If a bone infection, called os-
teomyelitis, develops or infection spreads through the
bloodstream, aggressive treatment with antibiotics over the
course of several weeks may be required.

Expected results

With proper treatment, bedsores should begin to
heal two to four weeks after treatment begins. Left un-
treated, however, gangrene, osteomyelitis, or a systemic
infection may develop. In the United States, about
60,000 deaths a year are attributable to complications
caused by bedsores.

Prevention

Prompt medical attention can prevent pressure sores
from deepening into more serious infections. People
whose movement or sense of touch is limited by disabili-
ty and disease should be monitored to insure that the skin
remains clean, dry, healthy. A bedridden patient should be
repositioned at least once every two hours while awake. A
person who uses a wheelchair should remember to shift
the body’s position often or they should be helped to
reposition the body at least once an hour. To avoid injury,
it is important to lift, rather than drag, a person being
repositioned. Wheelchair users should sit up as straight as
possible, with pillows behind the head and between the
legs if needed. Donut-shaped seat cushions should not be
used because they may restrict blood flow.

191

Bedsores

Bedwetting

KEY TERMS

Disuse atrophy — Condition of muscles that have
lost size, strength, and function due to lack of mo-
bility.

Gangrene — A serious condition where there is
decay or death of an organ, tissue, or bone caused
by a lack of oxygen and nutrients and by bacterial
infections.

Incontinence — Inability to control bladder or
bowel movements.

Inflammation — An immune reaction to tissue in-
jury or damage, usually characterized by pain,
swelling and redness.

Poultice — Moistened herbs applied directly to a
site of injury or infection.

Tactile sense — Receiving information about the
body and the environment via contact with the
skin. When this is lost through illness, a person
may receive injuries without being aware of it.

Even slight friction can remove the top layer of skin
and damage the blood vessels beneath it. Pillows or foam
wedges can be used to keep the ankles from rubbing to-
gether and irritating each other; pillows placed under the
lower legs can raise the heels off the bed. To minimize
pressure sores, there should be adequate padding in beds,
chairs, and wheelchairs. Those who are bed-ridden can
be protected by using sheepskin pads, specialized cush-
ions, and mattresses filled with air or water. In addition,
a 1997 study indicates that topical use of essential fatty
acids can help the skin stay healthy.

Resources

BOOKS

Berkow, MD, Robert, editor-in-chief, et al The Merck Manual
of Medical Information, Home Edition. New York: Pocket
Books, 1997.

The Editors of Time-Life Books The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments Virginia: Time-Life, Inc., 1996.

PERIODICALS

Declair, V. Ostomy Wound Management 43, no. 5 (1997): 48-52.

ORGANIZATIONS

International Association of Enterstomal Therapy, 27241 La
Paz Road, Suite 121, Laguna Niguel, CA 92656
National Pressure Ulcer Advisory Panel, SUNY at Buffalo,
Beck Hall, 3435 Main Street, Buffalo, NY 14214
<http://www.npuap.org.>

Patience Paradox

192

Bedwetting

Definition

Bedwetting, or enuresis, is a childhood condition of
urinating in bed while asleep at night. It is a chronic condi-
tion that often resolves by itself before the teenage years.

Description

One of the major tasks of toddlerhood is to learn
how to achieve conscious control over the timing of uri-
nation. Most children do not become fully toilet trained
until they are about two to four years old. Before then,
the parts of the nervous system in charge of bladder con-
trol are not fully developed and functional. In general,
boys take longer to learn to control their bladders than
girls, and daytime bladder control is easier for a child
than overnight bladder control. There is a genetic aspect
to bedwetting, so that parents who once had the condi-
tion often have children who wet the bed at night.

Causes & symptoms

Bedwetting is often due to the normal immaturity of
the nervous system and the urinary system. For instance,
up to age six, bedwetting is often due to nothing more
than the bladder having a small capacity. In addition, the
muscles that control the opening and closing of the ure-
thra may not be sufficiently developed. Often it takes a
while for a child learn recognition of bladder fullness,
waking up, and going to the toilet. In most cases, urinary
capacity and control increase over time, and the bedwet-
ting problem will eventually be outgrown.

Surprisingly, a big cause of bedwetting is lack of sleep.
If a child is not sleeping enough hours, then there will be less
of the light, rapid eye movement (REM) sleep, and more pe-
riods of heavy, deep sleep. During the periods of deep sleep
some children will have difficulty becoming aware of the
urge to urinate and awakening to go to the toilet.

Bedwetting may be a sign of allergic reactions,
which end up irritating sphincter muscles around the ure-
thra. This contributes to a loss of bladder control during
sleep. Heavy snoring, mouth breathing, and night sweats
may all be indications of the presence of allergies.

Bedwetting can sometimes be due to emotional and
psychological stress, including major life changes such as
moving or a divorce. This usually leads to the type of bed-
wetting called secondary enuresis, in which a previous
level of accomplishment with bladder control is lost. In
other words, a child who has been dry at night will sud-
denly start wetting the bed again. This may indicate an un-
derlying problem such as constipation, diabetes, physical

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

defects in the urinary tract, sacral nerve disorders, a pelvic
growth, urinary stasis, infection, kidney stones, or kidney
damage. Secondary enuresis also frequently occurs in
children who are being physically or sexually abused. A
pediatrician should be consulted if the condition persists.

Only about 1% of bedwetting is caused by a serious
underlying problem. If the following symptoms are pre-
sent, a pediatrician or a pediatric urologist should be
consulted:

• straining during urination

• a burning feeling or other discomfort during urination

• constant or recurrent dribbling of urine

• cloudy or pink urine

• bloodstains or other discharge on underpants or night-
clothes

• an unpleasant urine odor

• onset of abdominal pain, backache, or fever

• constant thirst, especially at night

• sudden loss of bladder control previously mastered

• a child over the age of two who still shows no signs of
being ready to learn bladder control

Diagnosis

When bedwetting is resistant to home treatments or
when more serious symptoms are present, a visit should
be made to a healthcare provider. This is especially war-
ranted if the child is older than six. A thorough history and
physical exam should be taken along with a urine sample.
Analysis and culture tests can be done on the urine to de-
termine if an infection is present. Further evaluations may
be made using ultrasound, an x ray of the kidney, or a con-
sultation with a urologist. If the bedwetting appears to be
connected with issues of stress or family problems, a men-
tal health consultation may be recommended.

Treatment

Sitting in a cool sitz bath (pelvic area only im-
mersed) for about five minutes daily can tone up the ure-
thral sphincter. This can be done using a bathtub filled
with about two or three inches of water, having the child
sit in a large basin of water or using a sitz basin (avail-
able from larger drugstores and medical supply stores).

“Hands-on” treatments such as acupressure, reflex-
ology, and shiatsu can be used to relax the child, coun-
teract stress, and improve the actions of the nervous sys-
tem. Hypnotherapy can also be helpful in improving
bedwetting. Among other things, the child will be given
positive goal affirmations to say before going to bed.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

This should help make the urge to urinate during the
night more conscious, and therefore encourage the child
to awaken and go to the toilet.

The best way to use homeopathy is o see a home-
opath for individual prescribing. Equisetum 6c, may be
useful, especially if there are dreams or nightmares con-
nected with the bedwetting. For bedwetting in very ex-
citable, outgoing children, which occurs soon after
falling asleep, Causticum 6c may be recommended. The
remedies should be given once per day at bedtime for up
to two weeks. A practitioner should be consulted for
more specific remedies.

Herbal medicine

A strong tea can also be made using equal parts of
horsetail, Equisetum arvense; St. John’s wort; cornsilk,
Zea mays; and lemon balm, Melissa ojfinalis. Two to
three handfuls of the mixture should be placed in a quart
or liter jar and then covered with boiling water. The tea
should be allowed to steep overnight. The child should be
given half a cup of the tea three times per day, with the
last dose being given at least two hours before bedtime.

Nettles, Urtica dioica, can be made into a pleasant
tea and consumed throughout the day as a tonic for the
kidneys. The tea can be mixed with equal parts of fruit
juice as a pleasant drink for the child.

Aromatherapy uses the essential oil of cypress, Cu-
pressus sempervirens to treat chronic bedwetting. Sever-
al drops of cypress oil should be put in olive oil for mas-
sage. The oil should be rubbed onto the child’s stomach
right before bedtime.

Behavior modification programs may be suggested.
In one type, alarms that are triggered by body moisture
are worn overnight, waking the child at the first sign of
bedwetting. The child can then go use the toilet to finish
emptying the bladder. This will eventually train the child
to awaken and use the toilet upon experiencing the sen-
sation of a full bladder. Nighttime toilet training using
the alarm may take up to four or five months to be effec-
tive, however. Another program uses the child’s help
with urinating before going to bed, recording wet and
dry nights, changing wet clothing and bedding, and dis-
cussing progress. Positive reinforcements, such as gold
stars on a chart and other rewards, are given for nights
that the child does not urinate in bed.

Allopathic treatment

If other treatments fail to work, treatment with medica-
tion may be suggested. With the use of the drug
imipramine, improvement will usually occur in the first
week of treatment if it is going to be helpful. The drug can

193

Bedwetting

Bee pollen

KEY TERMS

Antidiuretic — A substance that diminishes the for-
mation of urine.

Behavior modification — Therapy aimed at chang-
ing behavior by substituting problem behaviors
with more useful activities.

Culture test — A laboratory test to grow samples of
an infecting organism from discharge or samples
of affected tissue.

Diuretic — A substance that stimulates the forma-
tion and excretion of urine.

Rapid eye movement sleep — A stage of sleep dur-
ing which dreams occur. This stage usually alter-
nates with a heavier, more restful stage of sleep.

Sitz bath — A hydrotherapy treatment for soaking
the pelvic or genital areas.

Urethra — The tube that drains urine from the
bladder.

Urologist — A physician who specializes in treat-
ing problems of the urinary tract.

be discontinued if it does not work within a week or after a
month has gone by with no bedwetting. Unfortunately, re-
lapses are very common with this treatment. Also, since
imipramine is a strong drug, the blood needs to be tested
every other week for abnormal side effects. A nasal spray
containing Demopressin, an antidiuretic drug, has been
shown to be effective in diminishing bedwetting. It is neces-
sary to use the spray at least four to six weeks for maximum
effectiveness. Demopressin also has negative side effects
and is, therefore, only recommended for short-term use.

Expected results

Bedwetting is usually outgrown at some point.
However, underlying disease conditions may have to be
assessed and treated.

Prevention

Caffeine has a diuretic effect, and should be avoided.
It is found in coffee, chocolate, tea, and many sodas. Food
labels should be examined to determine caffeine content.

Resources

BOOKS

The Editors of Time-Life Books. The Medical Advisor: The
Complete Guide to Alternative and Conventional Treat-
ments. Virginia: Time-Life, Inc., 1996.

Kirchheimer, Sid and the editors of Prevention Magazine
Health Books. The Doctors Book of Home Remedies II:
Over 1 .200 New Doctor-Tested Tips and Techniques Any-
one Can Use to Heal Hundreds of Everyday Health Prob-
lems. Pennsylvania: Rodale Press, 1993.

Lockie, Dr. Andrew and Dr. Nicola Geddes. The Complete
Guide to homeopathy: The principles and Practice of
Treatment with a Comprehensive Range of Self-Help
Remedies for Common Ailments. London: Dorling
Kindersley, Ltd., 1995.

OTHER

AlternativeMedicine.com. http://www.alternativemedicine.com

American Academy of Pediatrics, <http://www.aap.org/family/
bedwet.htm. >

Medicinal Herbs Online, <http://www.egregore.com/diseases/
bedwetting.html.>

Patience Paradox

Bee pollen

Description

Bee pollen is the dust-size male seed found on the
stamen of any flower blossom. The pollen collects on the
legs of honeybees as they move from flower to flower.
The bees secrete a number of enzymes into the pollen.
Pollen is usually collected commercially by placing a spe-
cial device at the entrance of beehives that brushes the
substance from their hind legs into a collection receptacle.

General use

Bee pollen is among the oldest known dietary sup-
plements. Its use as a rejuvenator and medicine date back
to the early Egyptians and ancient Chinese. It has been
called many things, from a fountain of youth to an “am-
brosia of the gods.” The Greek physician Hippocrates,
sometimes called the father of modern medicine, used it
as a healing substance 2,500 years ago. It is rich in vita-
mins, especially B vitamins, and contains trace amounts
of minerals, elements, amino acids, and enzymes.

The pollen is composed of 55% carbohydrates, 35%
protein, 3% minerals and vitamins, 2% fatty acids, and
5% other substances. It contains very small amounts of
many substances considered to be antioxidants, includ-
ing betacarotene, vitamins C and E, lycopene, selenium,
and flavonoids.

Proponents of bee pollen offer a wide range of claims
regarding its nutritional and healing properties. These in-
clude enhancing the immune system, controlling weight,
relieving allergy symptoms, increasing strength, improv-
ing sexual function, enhancing vitality and stamina, slow-

194

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

mg the aging process, and prolonging life. None of these
claims have been substantiated by scientific studies.

Bee pollen is said to strengthen the immune system
through its antioxidant properties. Antioxidants are used
to deactivate free radicals in the body. Free radicals are
byproducts of oxygen that can damage cells and are
linked to many degenerative diseases, especially those
associated with aging. They are also associated with the
aging process itself. Antioxidants may block further
damage and even reverse much of the cell oxidation al-
ready done. Bee pollen is suggested to help counteract
the effects of radiation and environmental pollutants that
weaken the immune system, supporters say.

In the January 2000 issue of Bee Online , an Internet
publication of the American Apitherapy Society, Steve
Schecter, naturopathic doctor, said bee pollen is benefi-
cial in reducing the effects of radiation treatment in
women with cancer. A group of 25 women undergoing
treatment for uterine cancer also took 20 g (about two
teaspoons) of bee pollen three times a day. The women
reported improvements in their appetites and sense of
well being, and less severe nausea associated with radia-
tion therapy. Their serum protein levels increased and
red and white blood cell counts also improved.

Although many plant pollens can cause or exacer-
bate allergies and hay fever, bee pollen can actually
help reduce the symptoms of these conditions. Local bee
pollen therapy is recommended to start before the allergy
season begins and it may take a few weeks for the pollen
to work. According to an article in the February 1998
issue of Better Nutrition , an Oklahoma allergist success-
fully used bee pollen to treat 22,000 patients with aller-
gies. However, those allergic to bee stings may experi-
ence severe (anaphylactic) reactions to the pollen.

Bee pollen is often used by athletes to improve
strength, endurance, energy, and speed. It is said to help
muscles recover more quickly from exercise and to in-
crease mental stamina. “Bee pollen is used by almost
every Olympic athlete in the world,” said James Higgins,
treasurer of the American Apitherapy Society, in an inter-
view in the August 1999 issue of Better Nutrition. “It
gives them more energy and better performance for events
like marathons, and they aren’t as exhausted the next day.”

Preparations

It takes about two hours for bee pollen to be absorbed
into the bloodstream. It is available in health food stores in
gelatin capsules, tablets, and granules. Capsules and tablets
generally contain 500-1000 mg of bee pollen. A 100-count
bottle costs $5-8 on average. Granules are sold by the
ounce or pound. A one-pound bag costs about $20. The
recommended dosages for preventative purposes are an

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Bee pollen of various types. (Photo Researchers, Inc. Repro-
duced by permission.)

eighth to a quarter teaspoon of granules once a day to start,
gradually increasing over a month to one to two teaspoons,
one to three times a day. The dosage for short-term thera-
peutic use is 3/8-3/4 teaspoon to start, increasing to three to
six teaspoons, one to three times a day. The recommended
preventative dosage for capsules is two 450-580 mg cap-
sules, three to four times a day, and three times that dosage
for therapeutic purposes. Bee pollen is also available in liq-
uid, cream, salve, and tincture form, mainly for use on skin
conditions, sores, pounds, and bruises. Bee pollen should
not be heated, since it will lose its potency.

Precautions

Persons who are allergic to bee stings or products
should not use bee pollen since it may cause a serious aller-
gic reaction, including death. Anyone uncertain if they are
allergic to bee pollen should sample only a few granules
first to see if there is any type of reaction, or have an allergy
test. Those using bee pollen to reduce hay fever should be
sure to consume local bee pollen to obtain the best results.

Side effects

There are rare cases of minor side effects, such as
gastrointestinal irritation and diarrhea, associated with
ingesting bee pollen.

Interactions

Bee pollen has no known negative interactions with
other drugs, vitamins, or supplements.

Resources

BOOKS

Balch, James F. Prescription for Nutritional Healing. Avery

Publishing Group, 1997.

Elkins, Rita. Bee Pollen, Royal Jelly, Propolis, and Honey: An

Extraordinary Energy and Health-Promoting Ensemble.

Woodland Publishing, 1999.

195

Bee pollen

Behavioral optometry

KEY TERMS

Antioxidant — A substance that opposes oxidation
damage anywhere in the body caused by free oxy-
gen radicals.

Flavonoids — A group of about 5,000 substances,
mostly derived from food, that have super antioxi-
dant qualities.

Free oxygen radicals — Also called free radicals,
these are by-products of oxygen that cause oxida-
tive damage to the body's cells.

Gout — A disease causing inflammation of the
joints, especially the knees, toes, and fingers due
to the deposit of crystallized uric acid in the
joints.

Stamen — The male fertilizing organ of flowering
plants, bearing pollen.

Uric acid — A compound that can form deposits in
joints and tissues. This disease is known as gout or
hyperuricemia.

Geelhoed, Glenn W. and Jean Barilla. Natural Health Secrets
From Around the World. Keats Publishing, 1997.

Jensen, Bernard. Bee Well. Bee Wise. Bernard Jensen Publisher,
1994.

Wade, Carlson. Carlson Wade's New Fact Book on Bee Pollen
and Your Health. Keats Publishing, 1994.

PERIODICALS

Adderly, Brenda. “The Latest Buzz on Products of the Hive.”
Better Nutrition (August 1999): 42.

Hovey, Sue. "One Pill Makes You Larger.” Women's Sports and
Fitness (April 1997): 79-80.

Satel, Sally and James Taranto. “Bogus Bee Pollen.” The New
Republic (January 8, 1996): 24-26.

Scheer, James.“Products of the Hive: Sticky, Sweet and Health-
ful." Better Nutrition (February 1998): 60-63.

Somer, Elizabeth.“Tasty Relief: The Benefits of Using Food as
Nutrition." Men's Fitness (July 1998): 44-46.

ORGANIZATIONS

American Apitherapy Society. 5390 Grande Road, Hillsboro,
OH 45133. (937) 364-1108. aasoffice@in-touch.net.
http ://www. apitherapy. org .

Ken R. Wells

Bee sting therapy see Apitherapy
Bee stings see Bites and stings

Behavioral medicine see Mind/Body
medicine

196

Behavioral optometry

Definition

Behavioral optometry is a system of eye care that
emphasizes visual training as a way to improve the way
a patient uses his or her eyes. Rather than simply pre-
scribe lenses to compensate for eyesight weaknesses, be-
havioral optometrists attempt to train the patient to see
better across a range of different circumstances.

Origins

Behavioral optometry traces its roots to the writings
of Dr. William H. Bates, a New York City ophthalmolo-
gist. Bates began writing in the 1920s about alternatives
to the use of corrective lenses. He believed that many
physical and emotional stresses caused vision problems,
and that alleviating these stresses could improve vision.
He noted that modern humans spend an inordinate
amount of time doing close work such as reading, while
the human eye may have been originally adapted for dis-
tance vision. Bates devised a program of eye training
that allowed patients to gradually improve their vision
without glasses. The English novelist Aldous Huxley re-
covered from near-blindness using Bates’s system, and
wrote a book about his experience. Other optometrists
built on Bates’s insights, supplementing his research and
ideas. Some researchers focused on the fact that the need
for corrective lenses rises in proportion to a person’s
level of education. They concluded that the stress of
reading was probably responsible for poor eyesight. Oth-
ers noted that vision problems increase as cultures be-
come increasingly industrialized and developed. Practi-
tioners of behavioral optometry who built on and extend-
ed Bates’s ideas include Dr. Raymond L. Gottlieb and
Dr. Jacob Liberman, both influential authors and teach-
ers. Behavioral optometrists are distinctly a minority in
the field of optometry, but they can be found across the
United States and worldwide.

Benefits

Behavioral optometrists promise many benefits
from this way of treating vision problems. Perhaps the
foremost is that people can learn to live without the dis-
comfort and bother of wearing eyeglasses or contact
lenses. Behavioral optometry also focuses on children,
particularly those with learning difficulties. These chil-
dren can benefit from learning to train their eyes and so
overcome reading problems due to inability to concen-
trate or inability to keep the eyes in place on the page.
Behavioral optometry also tries to help patients deal with
stress, so that vision training can lead to a more relaxed

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

and healthy lifestyle. In addition, behavioral optometry
has been used to develop the special visual acuity that is
needed for sports; and some practitioners are trained to
treat patients who have suffered vision trauma such as
stroke, or to work with autistic or disabled children.

Description

Behavioral optometry aims to treat the whole patient,
not just correct his or her vision. The first step in an ex-
amination may be a wide-ranging series of tests and ques-
tions, geared to determine the patient’s overall visual
abilities. This term means not just how well the eyes read
letters on a chart, but such broader areas of visual percep-
tion as hand-eye coordination and color perception. Be-
havioral optometrists will prescribe corrective lenses, but
these are usually somewhat different from traditional
glasses. The lenses are designed to relieve the stress
caused by such close-focus work as reading or working at
a computer. But for distance seeing, the lenses may not
be as accurate as traditional lenses, since the behavioral
optometrist seeks to teach the eyes to relearn distance vi-
sion skills that have atrophied. Many behavioral op-
tometrists prescribe lenses that include a series of small
prisms, which are supposed to help the eyes develop bet-
ter vision patterns. Behavioral optometrists also practice
vision therapy, in which the optometrist works closely
with the patient in step-by-step exercises to help the eyes
relax and relearn lost skills. These are not merely eye ex-
ercises, because exercising the muscles around the eye
can fatigue them instead of strengthen them. The therapy
might involve learning new skills such as juggling, draw-
ing, dancing, or ball games, as well as relaxation tech-
niques. The optometrist may also work with the patient to
alter diet, sleep patterns, and lifestyle stress.

Research & general acceptance

Though behavioral optometrists are definitely a mi-
nority within the field of optometry, a body of research
supports their methods. This can be found in profession-
al journals such as Journal of Behavioral Optometry and
Journal of Optometric Vision Development. Bates’s
method has been in use since the 1920s, and much anec-
dotal evidence attests to its efficacy, including the dra-
matic case of writer Aldous Huxley. Other patients and
practitioners have written of their ability to function
without glasses and overcome learning disabilities
through behavioral optometry. And one of the major con-
tentions of behavioral optometry is that conventional op-
tometry does not cure the eye conditions it treats. My-
opic patients are given glasses, and then a stronger pair
of glasses, and then a stronger, as vision gradually wors-
ens. Behavioral optometrists use this development as ev-
idence that conventional optometry fails its patients.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Ophthalmologist — A physician who specializes in
treating diseases and disorders of the eye.

Optometrist — A professional who examines the
eyes for vision defects in order to fit the patient
with corrective lenses or prescribe other appropri-
ate treatment.

Training & certification

In the United States, there are three major training
institutions for behavioral optometry. The College of Op-
tometrists and Vision Development offers courses and
examinations leading to an international certificate in be-
havioral optometry. Clinical education workshops are of-
fered by the Optometric Extension Program Foundation
in Santa Ana, California. The Baltimore Academy of Be-
havioral Optometry offers in-depth coursework in behav-
ioral optometry to qualified optometrists. Only people
who already have a degree in optometry can take these
courses. Technicians also work with behavioral op-
tometrists. These technicians need have no specific edu-
cational background, but to become certified, they must
work for 2,000 hours under a certified behavioral op-
tometrist and pass a written and oral examination.

Resources

BOOKS

Bates, William. The Bates Method for Better Eyesight Without
Glasses. New York: Henry Holt & Co., 1981.

Liberman, Jacob. Take Off Your Glasses and See. New York:
Crown Publishers, 1995.

ORGANIZATIONS

Baltimore Academy of Behavioral Optometry. 16 Greenmeadow
Drive, Suite 103. Timonium, MD 21093. (800) 447-0370.
College of Optometrists in Vision Development. 353 H. Street,
Suite C. Chula Vista, CA 91910. (888) 268-3770.
Optometric Extension Program Foundation. 2912 South Daimler
Street, Suite 100. Santa Ana, CA 92705. (949) 250-8070.

Angela Woodward

Behavioral therapy

Definition

Behavioral therapy, or behavioral modification, is a
psychological technique based on the premise that spe-

197

Behavioral therapy

cific, observable, maladaptive, badly adjusted, or self-de-
structing behaviors can be modified by learning new,
more appropriate behaviors to replace them.

Origins

Reward and punishment systems have been used
throughout recorded history in an attempt to influence
behavior, from child rearing to the criminal justice sys-
tem. Modern behavioral therapy began in the 1950s with
the work of B.F. Skinner and Joseph Wolpe. Wolpe treat-
ed his patients who suffered from phobias with a tech-
nique he developed called systematic desensitization.
Systematic desensitization involved gradually exposing a
patient to an anxiety-provoking stimuli until the anxiety
response was extinguished, or eliminated.

Skinner introduced a behavioral technique he called
operant conditioning. Operant conditioning is based on
the idea that an individual will choose his behavior based
on past experiences of consequences of that behavior. If
a behavior was associated with positive reinforcements
or rewards in the past, the individual will choose it over
behavior associated with punishments.

By the 1970s, behavior therapy enjoyed widespread
popularity as a treatment approach. Over the past two
decades, the attention of behavioral therapists has fo-
cused increasingly on their clients’ cognitive processes,
and many therapists have begun to use cognitive behav-
ior therapy to change clients’ unhealthy behavior by re-
placing negative or self-defeating thought patterns with
more positive ones.

Benefits

Behavioral therapy can be a useful treatment tool in
an array of mental illnesses and symptoms of mental ill-
ness that involve maladaptive behavior, such as sub-
stance abuse, aggressive behavior, anger management,
eating disorders, phobias, and anxiety disorders. It is
also used to treat organic disorders such as incontinence
and insomnia by changing the behaviors that might be
contributing to these disorders.

Cognitive-behavioral therapy, an offshoot of behav-
ioral therapy that focuses on changing maladaptive be-
haviors by changing the faulty thinking patterns behind
them, is a recommended treatment option for a number
of mental disorders, including affective (mood) disor-
ders, personality disorders, social phobia,
schizophrenia, obsessive compulsive disorder (OCD),
agoraphobia, post-traumatic stress disorder (PTSD),
Alzheimer’s disease, and attention-deficit hyperactivi-
ty disorder (ADHD). It is also frequently used as a tool
to deal with chronic pain for patients with illnesses such
as rheumatoid arthritis, back problems, and cancer.

198

Behavioral therapy techniques are sometimes com-
bined with other psychological interventions such as med-
ication. Treatment depends on the individual patient and the
severity of symptoms surrounding the behavioral problem.

Description

Behavioral therapy, or behavior modification, is
based on the assumption that emotional problems, like
any behavior, are learned responses to the environment
and can be unlearned. Unlike psychodynamic therapies,
it does not focus on uncovering or understanding the un-
conscious motivations that may be behind the maladap-
tive behavior. In other words, behavioral therapists don’t
try to find out why their patients behave the way they do,
they just teach them to change the behavior.

initial treatment sessions are typically spent explain-
ing the basic tenets of behavioral therapy to the patient
and establishing a positive working relationship between
therapist and patient. Behavioral therapy is a collabora-
tive, action-oriented therapy, and as such, it empowers
patients by giving them an active role in the treatment
process. It also discourages overdependence on the ther-
apist, a situation that may occur in other therapeutic rela-
tionships. Treatment is typically administered in an out-
patient setting in either a group or individual session.
Treatment is relatively short compared to other forms of
psychotherapy, usually lasting no longer than 16 weeks
or sessions.

There are a number of different techniques used in
behavioral therapy to help patients change their behav-
iors. These include:

• Behavioral homework assignments. The therapist often
requests that the patient complete homework assign-
ments between therapy sessions. These may consist of
real-life behavioral experiments where patients are en-
couraged to try new responses to situations discussed in
therapy sessions.

• Contingency contracting. In conjunction with the pa-
tient, the therapist outlines a written or verbal contract of
desired behaviors for the patient. The contract may have
certain positive reinforcements (rewards) associated with
appropriate behaviors and negative reinforcements (pun-
ishments) associated with maladaptive behavior.

• Modeling. This is where the patient learns a new be-
havior through observation.

• Rehearsed behavior. The therapist and patient engage
in role-playing exercises in which the therapist acts out
appropriate behaviors or responses to situations.

• Skills training techniques. The patient undergoes an ed-
ucation program to learn social, parenting, or other rel-
evant life skills.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Conditioning. The therapist uses reinforcement to en-
courage a particular behavior. For example, a child
with ADHD may get a gold star every time he stays fo-
cused on tasks and accomplishes certain daily chores.
The gold star reinforces and increases the desired be-
havior by identifying it with something positive. Rein-
forcement can also be used to extinguish unwanted be-
haviors by imposing negative consequences (this is also
called punishment and response).

• Systematic desensitization. Patients are gradually ex-
posed to a situation they fear, either in a role-playing
situation or in reality. The therapist will employ relax-
ation techniques to help them cope with their fear reac-
tion and eventually eliminate the anxiety altogether.
For example, a patient in treatment for agoraphobia, a
fear of open or public places, will relax and then pic-
ture herself on the sidewalk outside of her house. In her
next session, she may relax herself and then imagine a
visit to a crowded shopping mall. The imagery gets
progressively more intense until eventually, the thera-
pist and patient approach the anxiety-producing situa-
tion in real life by visiting a mall. By repeatedly pairing
a desired response (relaxation) with a fear-producing
situation (open, public spaces), the patient gradually
becomes desensitized to the old response of fear and
learns to react with feelings of relaxation.

• Flooding. Flooding is an accelerated version of system-
atic desensitization, in which the patient is exposed di-
rectly to the anxiety-provoking situation that he fears
most (either through mental visualization or real life
contact) in an effort to extinguish the fear response.

• Progressive relaxation. As the name implies, progres-
sive relaxation involves complete relaxation of the
muscle groups of the body and calm and even breathing
until the body is completely tension free. It is used by
behavioral therapists both as a relaxation exercise to re-
lieve anxiety and stress, and as a method of preparing
the patient for systematic desensitization. Progressive
relaxation is performed by first tensing and then relax-
ing the muscles of the body, one group at a time. The
therapist may suggest that the patient use one of many
available instructional relaxation tapes for practicing
this technique at home.

Cognitive-behavioral therapy (CBT) integrates fea-
tures of behavioral modification into the traditional cog-
nitive restructuring approach. In cognitive-behavioral
therapy, the therapist works with the patient to identify
the thoughts that are causing distress, and employs be-
havioral therapy techniques to alter the resulting behav-
ior. Patients may have certain fundamental core beliefs,
known as schemas, which are flawed and are having a
negative impact on the patient’s behavior and function-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ing. For example, a patient suffering from depression
may develop a social phobia because he is convinced he
is uninteresting and unlikable. A cognitive-behavioral
therapist would test this assumption, or schema, by ask-
ing the patient to name family and friends that care for
him and enjoy his company. By showing the patient that
others value him, the therapist exposes the irrationality
of the patient’s assumption. He also provides a new
model of thought for the patient to change his previous
behavior pattern (i.e., I am an interesting and likeable
person, therefore I should not have any problem making
new social acquaintances). Additional behavioral tech-
niques such as conditioning (the use of positive and/or
negative reinforcements to encourage desired behavior)
and systematic desensitization (gradual exposure to anxi-
ety-producing situations in order to extinguish the fear
response) may then be used to gradually reintroduce the
patient to social situations.

Additional treatment techniques that may be em-
ployed with cognitive-behavioral therapy include:

• Cognitive rehearsal. The patient imagines a difficult sit-
uation, and the therapist guides him through the step-
by-step process of facing and successfully dealing with
it. The patient then works on practicing, or rehearsing,
these steps mentally. Ideally, when the situation arises
in real life, the patient will draw on the rehearsed be-
havior to address it.

• Journal therapy. Patients are asked to keep a detailed
diary recounting their thoughts, feelings, and actions
when specific situations arise. The journal helps to
make the patient aware of his or her maladaptive
thoughts and to show their consequences on behavior.
In later stages of therapy, it may serve to demonstrate
and reinforce positive behavior.

• Validity testing. Patients are asked to test the validity of
the automatic thoughts and schemas they encounter.
The therapist may ask the patient to defend or produce
evidence that a schema is true. If the patient is unable
to meet the challenge, the faulty nature of that schema
is exposed.

Biofeedback is a patient-guided treatment that is
also associated with behavioral therapy. Biofeedback
teaches an individual to control muscle tension, pain,
body temperature, brain waves, and other bodily func-
tions and processes through relaxation, visualization,
and other techniques. In some cases, positive reinforce-
ments are used to reward patients who generate the cor-
rect biofeedback response during treatment. The name
biofeedback refers to the biological signals that are fed
back to the patient in order for the patient to develop
techniques of controlling them.

199

Behavioral therapy

KEY TERMS

Cognitive-behavioral therapy — An offshoot of be-
havioral therapy that focuses on changing mal-
adaptive behaviors by changing the faulty thinking
patterns behind them.

Cognitive restructuring — A technique used in
cognitive-behavioral therapy. The process of re-
placing maladaptive thought patterns with con-
structive thoughts and beliefs.

Maladaptive — Unsuitable; maladaptive behavior is
behavior that is inappropriate to a given situation.

Psychodynamic therapy — A therapeutic approach
that assumes improper or unwanted behavior is
caused by unconscious, internal conflicts and fo-
cuses on gaining insight into these motivations.

Relapse — A return of behaviors or symptoms after
initial treatment.

Schemas — Fundamental core beliefs or assump-
tions that are part of the perceptual filter people
view the world through. Cognitive-behavioral
therapy seeks to change maladaptive schemas.

Preparations

Patients may seek therapy independently, or be referred
for treatment by a primary physician, psychologist, psychia-
trist, or other healthcare professional. Because the patient
and therapist work closely together to achieve specific thera-
peutic objectives, it is important that their working relation-
ship be comfortable and that their treatment goals are com-
patible. Prior to beginning treatment, the patient and thera-
pist should meet for a consultation session, or mutual inter-
view. The consultation gives the therapist the opportunity to
make an initial assessment (a detailed behavioral analysis of
the particular incidents which lead up to and ensue after a
specific unwanted behavior) of the patient and recommend a
course of treatment and goals for therapy. It also gives the
patient an opportunity to find out important details about the
therapist’s approach to treatment, professional credentials,
and any other relevant issues important to them.

In some managed-care clinical settings, an intake in-
terview or evaluation is required before a patient begins
therapy. The intake interview is used to evaluate the pa-
tient and assign him or her to a therapist. It may be con-
ducted by a psychiatric nurse, counselor, or social worker.

Precautions

Behavioral therapy may not be suitable for some
patients. Those who don’t have a specific behavioral

200

issue they wish to address and whose goals for thera-
py are to gain insight into the past may be better
served by psychodynamic therapy. Patients must also
be willing to take a very active role in the treatment
process.

Behavioral therapy may also be inappropriate for
cognitively-impaired individuals (e.g., patients with or-
ganic brain disease or a traumatic brain injury) depend-
ing on their level of functioning.

Because of the brief nature of behavioral therapy, re-
lapse has been reported in some patient populations.
However, follow-up sessions can frequently put patients
back on track to recovery.

Research & general acceptance

The use of behavioral modification techniques to
treat an array of mental health problems have been ex-
tensively described and studied in medical literature.
There may be some debate among mental health pro-
fessionals as to whether behavioral therapy should be
considered a first line treatment for some mental ill-
nesses, and to what degree other treatments such as
medication should be employed as an adjunct, or com-
plementary, therapy. However, the general consensus
seems to be that behavioral therapy techniques can be a
powerful treatment tool for helping patients change un-
desirable behaviors.

Training & certification

Behavioral therapists are typically psychologists
(Ph.D., Psy.D., Ed.D., or M.A. degree), clinical social
workers (M.S.W., D.S.W., or L.S.W. degree), counselors
(M.A. or M.S. degree), or psychiatrists (M.D. with spe-
cialization in psychiatry). Other healthcare providers
may suggest brief behavioral interventions, but more ex-
tensive treatment should be left to individuals who are
trained in behavioral therapy techniques.

Resources

BOOKS

Mills, John. Control: A History of Behavioral Psychology. New
York: New York University Press, 1998.

PERIODICALS

Gelder, M.“The Future of Behavior Therapy.” Journal of Psy-
chotherapy Practice. 6, no. 4 (Fall 1997):285-93.

ORGANIZATIONS

The National Association of Cognitive-Behavioral Therapists.
P.O. Box 2195, Weirton, WV 26062. (800)853-1135.

Paula Ford-Martin

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Belladonna

Description

Belladonna, more commonly known as deadly night-
shade, Atropa belladonna , devil’s cherries, devil’s herb,
divale, dwale, dwayberry, great morel, naughty man’s
cherries, and poison black cherry, is a perennial herb that
has been valued for its medicinal properties for over five
centuries. Belladonna is a member of the Solanaceae
(nightshade) family, and can be identified by its bell-
shaped, purple flowers and cherry-sized green berries that
mature to a dark purple or black color. The tall, branching
plant can grow to a height of at least 5 ft (1.5 m), and is
native to Europe, North Africa, and Asia and cultivated in
North America and the United Kingdom. Belladonna has
also been introduced to a number of places, including the
United States and Ireland and now grows wild.

Belladonna leaves are large (up to 10 in [25.4 cm] in
length) and grow in pairs on either side of the plant stem.
Near the flowers or blossoms, one of each leaf pair is no-
ticeably smaller in size. Both the leaves and root have a
sharp, unpleasant odor and bitter taste. As the name
deadly nightshade suggests, the herb is highly toxic if
taken even when taken in extremely low concentrations.

One of the first widespread uses of the herb was
purely a cosmetic one. Sixteenth century Italian women
reportedly applied belladonna solutions to their eyes to
dilate the pupils and achieve a dreamy and supposedly
more desirable appearance (hence the name belladonna,
which is Italian for ‘beautiful lady’). Atropine, an alka-
loid of belladonna that blocks certain nerve impulses, is
still used by some opthamologists today to dilate the
pupils for eye exams.

General use

Belladonna has a long history of medicinal applica-
tions in healthcare. Belladonna alkaloids are anticholin-
ergic, which means that it works by blocking the certain
nerve impulses involved in the parasympathetic nervous
system, which regulates certain involuntary bodily func-
tions or reflexes, including pupil dilation, heart rate, se-
cretion of glands and organs, and the constriction of the
bronchioles in the lungs and the alimentary canal (diges-
tive tract). Belladonna relaxes the smooth muscles of the
internal organs and inhibits or dries up secretions (e.g.,
perspiration, mucous, breast milk, and saliva).

Belladonna alkaloids, the active ingredients of the
plant, include atropine and scopolamine. These alkaloids
are extracted from the leaves and root of the plant and
administered either alone or in combination with other
herbal remedies or prescription medications. However

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Belladonna plant. (Photo Researchers, Inc. Reproduced by
permission.)

even tiny doses are toxic and should only be taken by

prescription.

Belladonna alkaloids are used to treat a variety of

symptoms and conditions, including:

• Gastrointestinal disorders. Because the alkaloids relax
the smooth muscles of the gastrointestinal tract and re-
duces stomach acid secretions, it is useful in treating
colitis, diverticulitis, irritable bowel syndrome, colic,
diarrhea, and peptic ulcer.

• Asthma. By relaxing the bronchioles, belladonna alle-
viates the wheezing symptoms of an asthma attack.

• Excessive sweating. Belladonna slows gland and organ
secretion, which makes it useful in controlling condi-
tions that cause excessive sweating.

• Nighttime incontinence. Belladonna acts as a diuretic,
and can be helpful in treating excessive nighttime uri-
nation and incontinence.

• Headaches and migraines. The pain-relieving proper-
ties of atropine, a belladonna alkaloid, are useful in
treating headaches.

• Muscle pains and spasms. Belladonna is frequently
prescribed to ease severe menstrual cramps.

201

Belladonna

• Motion sickness. Scopolamine, an alkaloid of bel-
ladonna, is helpful in treating motion sickness and ver-
tigo.

• Parkinson’s disease. Belladonna can alleviate the exces-
sive sweating and salivation associated with the disease,
as well as controlling tremors and muscle rigidity.

• Biliary colic. Muscle spasm, or colic, of the gallbladder
and liver can be relieved through the muscle relaxing
properties of belladonna.

Homeopathic use

Belladonna is frequently prescribed homeopathic
remedy used to treat illnesses that manifest symptoms
similar to those that belladonna poisoning triggers (i.e.,
high fever, nausea, delirium, muscle spasms, flushed
skin, dilated pupils). These include the common cold,
otitis media (earache), fever, arthritis, menstrual cramps,
diverticulitis, muscle pain, sunstroke, toothache and
teething, conjunctivitis, headaches, sore throat, and
boils and abscesses. As with all homeopathic remedies,
the prescription of belladonna depends on the individ-
ual’s overall symptom picture, mood, and temperament.
When used as a homeopathic remedy, belladonna is ad-
ministered in a highly diluted form to trigger the body’s
natural healing response without risk of belladonna poi-
soning or death.

Results of a clinical trial performed at the National
Cancer Institute of Milan, Italy, have also indicated that
homeopathic remedies of belladonna can be useful in re-
lieving the discomfort, warmth, and swelling of the skin
associated with radiotherapy for breast cancer (i.e., ra-
diodermatitis).

Preparations

Belladonna leaf is harvested between May and July
and dried at temperatures no warmer than 140°F (60° C).
The roots of Atropa belladonna plants that have reached
two to four year old maturity are also harvested for
herbal preparations in early fall between mid-October
and mid-November. The roots are then cleaned and dried
at temperatures no warmer than 122°F (50°C). After dry-
ing, the leaves and roots are crushed for use in a number
of forms, including decoctions, tinctures, infusions, plas-
ters, pills, suppositories, liquid solutions or suspensions,
and powders. They can be used both alone and in combi-
nation with other herbs and medications.

It is extremely dangerous to self-prescribe bel-
ladonna, and it should always be taken under the di-
rection of a doctor or other qualified healthcare pro-
fessional. The frequency and quantity of dosage will
depend on both the patient and the illness the herb is

202

prescribed for, but the doses are always extremely
small. For example the Physicians Desk Reference
(PDR) for Herbal Medicines recommends an average
single dose of 0.05-0.10 g. Each patient’s illness is
different and some patients experience toxicity at un-
usually low doses.

For homeopathic remedies, the plant is broken apart
and juice is extracted through a pressing process. The ex-
tract is then mixed with a water/alcohol solution by a
ratio of either 1:10 or 1:100, and this process is repeated
up to 30 times to form an extremely diluted dose of the
extract. Homeopathic belladonna remedy is generally
added to pellets of sugar for easier administration. The
dilution and dosage frequency depend on the symptoms
being treated, but homeopathic remedies are typically
administered only until the patient starts to show signs of
improvement so that the body’s natural healing response
can take over.

Belladonna is available by prescription both alone
(in high concentration strength) and in combination
with other drugs. Currently available prescription
combinations include belladonna with opium (for
uterine pain), kaolin and pectin (for diarrhea), pheno-
barbital (for menopausal symptoms and migraine pro-
phylactic), other barbiturates (for insomnia and for
cramping and muscle spasms in the digestive tract), or
belladonna and opium suppositories (for severe in-
testinal cramping).

Belladonna preparations should be stored in air-tight
containers away from direct light. Under these condi-
tions, most preparations will remain potent for up to
three years.

Precautions

Ingestion of high concentrations of atropine, a po-
tent alkaloid found in belladonna, can cause severe ill-
ness and death. Atropine is fatal in doses as small as 100
mg, which equals 5-50 g of belladonna herb, depending
on the potency of the particular plant. For children, a
fatal dose is even significantly less. For this reason, bel-
ladonna should never be used unless prescribed by a
trained practitioner.

Individuals suffering from kidney disease, intestinal
blockage, glaucoma, enlarged prostate, urinary block-
age, severe ulcerative colitis, or myasthenia gravis are
advised not to take belladonna, as are those patients with
a known allergy to belladonna. Patients with any chronic
health conditions should never take belladonna without a
doctor’s prescription.

Pregnant or breastfeeding women should avoid all but
homeopathic belladonna, unless prescribed by a doctor.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Because of the sedative qualities of belladonna, in-
dividuals taking the herb should use caution when dri-
ving or operating machinery. Alcohol and other central
nervous system (CNS) depressants should also be avoid-
ed, as they may increase drowsiness and dizziness in the
patient taking belladonna.

If individuals taking homeopathic dilutions of bel-
ladonna experience worsening of their symptoms
(known as a homeopathic aggravation), they should con-
tact their healthcare professional. A homeopathic aggra-
vation can be an early indication that a remedy is work-
ing properly, but it can also be a sign that a different
remedy is called for.

Side effects

Toxic signs of belladonna include dry mouth,
drowsiness, dizziness, constipation, and nausea. Some
side effects, including pupil dilation, blurred vision,
fever (due to the inability to perspire), inability to uri-
nate, arrhythmia, and excessive dry mouth and eyes, can
also be early indications of belladonna overdose. Indi-
viduals experiencing these side effects should inform
their health care practitioner immediately.

Belladonna overdose is also indicated by a burning
throat, delirium, restlessness and mania, hallucinations,
difficulty breathing, and flushed skin that is hot and dry.
Without proper treatment, constriction of the airway can
cause suffocation. If any of these symptoms occur, indi-
viduals should seek emergency medical attention imme-
diately. Treatment of belladonna overdose is typically
gastric lavage, which involves inserting a tube down the
patient’s throat and washing out the stomach with a solu-
tion of activated charcoal or tannic acid to neutralize
the atropine. Oxygen may also be required until breath-
ing is stabilized, and barbiturates may be administered to
counteract mania and/or excitation.

Interactions

Certain medications may increase the effects of bel-
ladonna. These include central nervous system (CNS)
depressants, monoamine oxidase (MAO) inhibitors, tri-
cyclic antidepressants, quinidine, amantadine, antihista-
mines, and other anticholinergics. Other medications,
including anticoagulants (blood thinners) and corti-
cotropin (ACTH), become less effective when used with
belladonna, while some drugs, such as diarrhea medi-
cines containing kaolin and attapulgite, may decrease
the therapeutic response to belladonna when they are
taken with the herb. If you are taking these or any other
medications or herbal remedies, let your healthcare pro-
fessional know.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Alkaloids — A chemical family that contains nitro-
gen.

Allopathic — Healthcare practice that uses reme-
dies and treatments that cause different effects
than the symptoms they are intended to treat; con-
ventional medicine is usually considered allopath-
ic in nature.

Anticholinergic — A medication or other sub-
stance which blocks certain parasympathetic
nerve impulses.

Decoction — An herbal extract produced by mix-
ing an herb in cold water, bringing the mixture to
a boil, and letting it simmer to extract water. The
decoction is then strained and drunk hot or cold.
Decoctions are usually chosen over infusion when
the botanical in question is a root or bark.
Homeopathic — Remedies and treatments that
cause similar effects to the symptoms they are in-
tended to treat in an effort to stimulate the bodies
natural immune response system.

Infusion — An herbal preparation made by pouring
boiling water over an herb and letting the brew
steep for 20 minutes, then straining. Tea is made
through infusion.

Mania — Hyperelevated, or excessively excited mood.

Naturalized — Plants which are introduced in the
wild.

Prophylactic — A preventative treatment.

Radiodermatitis — Red, irritated, and inflamed
skin caused by x-rays, radiation treatment, or
other radiation exposure.

Tinctures — An alcohol liquid extract of an herb.

USP — The U.S. Pharmacopoeia. Nationally and
internationally recognized drug standards pub-
lished by the United States Pharmacopeia Con-
vention, Inc. and used as a standard by FDA and
other federal regulatory agencies.

Alcohol, a CNS depressant, can also enhance the
sedative effect of belladonna, and should be avoided dur-
ing belladonna treatment.

Individuals considering treatment with homeopathic
dilutions of belladonna should consult their healthcare
professional about possible interactions with certain
foods, beverages, prescription medications, aromatic
compounds, and other environmental elements that could
counteract the efficacy of belladonna treatment.

203

Belladonna

Beta carotene

Resources

BOOKS

Jonas, Wayne B., M.D. and Jennifer Jacobs, M.D., M.P.H.
Healing With Homeopathy. New York: Warner Books,
1996.

Medical Economics Company. PDR for Herbal Medicines.
Montvale, NJ: Medical Economics Company, 1998.

PERIODICALS

Balzarini, A. et al. “Efficacy of homeopathic treatment of skin
reactions during radiotherapy for breast cancer: a ran-
domised, double-blind clinical trial ”, British Homeopath-
ic Journal. (January 2000) 89(1): 8-12.

Sahelian, Ray and Victoria Dolby Toews. “Give Colds the
Shoulder.” Better Nutrition. (October 1999) 61(10): 40-
44.

ORGANIZATIONS

The American Botanical Council. P.O. Box 144345, Austin,
TX 78714-4345. (512)926-4900. http://www.herbalgram.
org.

Office of Dietary Supplements. National Institutes of Health.
Building 31, Room 1B25, 31 Center Drive, MSC 2086,
Bethesda, Maryland 20892-2086. (301) 435-2920. Ods@
nih.gov. http://odp.od.nih.gov/ods/.

Paula Ford-Martin

Benign prostatic hypertrophy see Prostate
enlargement

Bernard training see Auditory integration
training

Beta carotene

Description

Beta carotene is one of the most important naturally
occurring antioxidants. It is a fat-soluble pigment found
in plants (notably carrots and many colorful vegetables
and fruits) and in the sea alga Dunaleilla salina and D.
bardawil. Naturalbeta carotene supplements are derived
primarily from D. salina. Beta carotene is one of the
major dietary carotenoids and one of the most biological-
ly active of approximately 800 carotenes and more than
1 ,000 carotenoids present in food. It is responsible for the
orange or yellow colors of many fruits and vegetables. In
the human body, beta carotene is found in lipids and in fat
tissues. Sometimes beta carotene is called provitamin A
because it is more easily converted to vitamin A (retinol)
in the liver than other carotenoids. Beta carotene is consid-
ered to be a conditionally essential nutrient because it be-
comes essential when vitamin A intake is low.

204

Beta carotene consists of a chain of 40 carbon
atoms, with conjugated double bonds and a ring struc-
ture at each end of the chain. Depending on the positions
of the molecular groups attached to the carbon chain,
naturally occurring beta carotene may be:

• All -trans beta-carotene

• 9 -cis beta-carotene

• 13-cis beta-carotene, in smaller amounts

Synthetic beta carotene is primarily all -trans.

In plants and alga, beta carotene and other caroten-
oids attract light for photosynthesis and provide protec-
tion from toxic forms of oxygen. Beta carotene is a pow-
erful antioxidant because it destroys toxic free radicals,
including singlet oxygen — an oxygen atom that is miss-
ing an electron and is very damaging to human tissue if
not taken up quickly and “deactivated.”

General use

Vitamin A precursor

Vitamin A is obtained in the diet from animal prod-
ucts or is made in the liver from beta carotene and other
carotenoids. Vitamin A is essential for:

• vision and eye health

• normal cell division

• growth

• reproduction and fertility

• immune system function

• skin and mucous membrane health

In sub-Saharan Africa about three million children
under the age of five suffer from an eye disorder, caused
by vitamin-A deficiency, that can lead to blindness and
death. Although red palm oil, a traditional African food,
contains high provitamin A, its substitution by imported
cooking oils has reduced this dietary source in many
homes. Many vegetables and fruits also contain provita-
min A, but are not always consumed in adequate
amounts. Vitamin A deficiency is the leading cause of
blindness worldwide.

In the 1920s vitamin-A deficiency was linked to
stomach cancer and to precancerous conditions in the
epithelial (lining) cells of the throat and lungs. In 1977
vitamin A supplementation was shown to inhibit certain
cancers and to reduce the growth of certain tumors in at-
risk animals.

Dietary beta carotene

Carotenoids, including beta carotene, that are ob-
tained from food may have:

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Vegetable

Serving International Units (IU)

Daily Allowance (DA)

Carrot

1 whole raw, 7.5 in (1 9 cm)

20,250

41 0%

Carrot

sliced and boiled, 0.5 cup (1 1 8 ml)

19,150

380%

Carrot juice

canned, 0.5 cup (1 1 8 ml)

12,915

260%

Spinach

frozed and boiled, 0.5 cup (1 1 8 ml)

7,395

1 50%

Sweet potatoes

canned and drained, 0.5 cup (1 1 8 ml)

7,015

140%

Mango

sliced raw, 0.5 cup (1 1 8 ml)

6,425

130%

Vegetable soup

canned, ready-to-serve, 1 cup (237 ml)

5,880

1 1 5%

Canteloupe

raw, 1 cup (237 ml)

5,160

1 00%

Kale

frozen and boiled, 0.5 cup (1 1 8 ml)

4,130

80%

Spinach

raw, 1 cup (237 ml)

2,015

40%

Apricot nectar

canned, 0.5 cup (1 1 8 ml)

1,650

35%

Oatmeal

1 packet instant plain

1,510

30%

Tomato juice

canned, 6 oz (1 77 ml)

1,010

20%

Apricots

2 halves with skin packed in juice

610

10%

Red pepper

1 raw ring, 3 in (7.8 cm); 0.25 in (0.64 cm) thick

570

10%

Peas

frozen and boiled, 0.5 cup (1 1 8 ml)

535

10%

Peaches

1 medium raw fruit

525

10%

Peaches

canned halves or slices in water, 1 cup (237 ml)

470

10%

Papaya

raw cubes, 1 cup (237 ml)

400

• antioxidant activity

• immune-system-enhancing activity

• activity against some cancers and precancerous conditions

• a role in preventing coronary heart disease, including
heart attack and stroke

Epidemiological studies that looked at cancer rates
and diet found that at least five daily servings of green,
orange, red, and yellow vegetables and fruits appeared to
significantly reduce the risk of stomach, lung, prostate,
breast, head, and neck cancer, and possibly slow the pro-
gression of others .In 1971 a large human study linked
cancer death rates to low levels of beta carotene in the
blood. Subsequent studies linked high blood levels of di-
etary beta carotene to lower cancer risks. However more
recent evidence links these results to a combination of
antioxidants found in fruits and vegetables, rather then to
beta carotene alone. High beta carotene levels in the
blood may be associated with a reduced risk of asthma.

Supplemental beta carotene

Supplemental beta carotene has been claimed to:

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• inhibit precancerous lesions in those at risk of oral cancer

• protect against gastric and esophageal cancers

• reduce the risk of prostate cancer

• lower the overall cancer risk

• protect against sunburn

However, there is very little evidence that supple-
mental beta carotene is an effective cancer-preventing
substance, except perhaps in those with poor nutrition
or low baseline levels of beta carotene in the blood. Ad-
ditional studies have shown that beta-carotene supple-
ments do not reduce the risk of cancer, heart disease, or
cataracts.

Yet supplemental beta carotene does appear to in-
crease the amounts of some types of immune-system
cells. Studies have shown that women with low dietary
intake or low blood levels of beta carotene are at in-
creased risk for cervical dysplasia (abnormal cell
growth) and cervical cancer. Another study found that
beta-carotene supplementation provided some protection
against the recurrence of colorectal adenoma (benign tu-

205

Beta carotene

mors) in patients who neither smoked nor drank alcohol.
However in patients who used tobacco and/or alcohol the
risk of recurrence increased with beta-carotene supple-
mentation. Studies of smokers and/or those who had
been exposed to asbestos initially found an increase in
lung cancers among those receiving supplemental beta
carotene (at least 20 mg per day), particularly among
those who also consumed large quantities of alcohol.
However follow-up studies found no such increases in
lung cancer in those taking beta carotene.

The Age-Related Eye Disease Study found that a
combined supplement of beta carotene, vitamin C, vita-
min E, zinc, and copper reduced the risk of disease pro-
gression and vision loss in people with advanced macular
degeneration. The supplement did not slow disease pro-
gression in those with early-stage macular degeneration.

One study found that supplementation with a mixture
of antioxidants — beta carotene, alpha-tocopherol, and
plant sterols — lowered cholesterol levels in the blood.

Beta carotene at 25,000 international units (IU)
daily may be useful for treating psoriasis, a skin condi-
tion. Beta carotene supplements also are used to treat
acne. Two 25,000-IU supplements daily, in combination
with other supplements, sometimes are used to treat
stomach ulcers.

Preparations

Measuring beta carotene

A recommended dietary allowance (RDA) for beta
carotene has not been established and most foods are not
labeled as to vitamin A content. There are two incompat-
ible systems for quantifying beta carotene. lUs are used
most often for nutritional labeling:

• 1 IU equals 0.6 pg of all -trans beta carotene

• 3.33 IU of all-trans beta carotene, 2 jug, is equal to 1 pg
of all -trans retinol (vitamin A)

• 5,000 IU equals 3 mg of beta carotene, the RDA for vi-
tamin A

• 1 IU equals 1 .2 pg of other provitamin A carotenoids

The second system uses retinol equivalents (RE):

• 1 RE equals 1 pg of all -trans retinol

• 1 RE equals 6 pg of all -trans beta carotene

• 1 RE equals 12 pg of other provitamin A carotenoids

Dietary beta carotene

Daily values (DVs) are determined from the RDA.
They are based on a 2,000-calorie diet and usually are
expressed as a percentage of an RDA. The IUs and DVs

206

for beta carotene, per serving, in common foods are list-
ed in table 1 .

Carrots and sweet potatoes that are more orange
contain more beta carotene. New carrot cultivars that
contain more beta carotene have been developed and
high-beta-carotene sweet potatoes are being introduced
into sub-Saharan Africa to treat vitamin-A deficiency.

Other foods that contain beta carotene include:

• avocados

• broccoli

• chard

• coffee

• collard greens

• palm oil and other food colorants

• squash

• string beans

• watermelon

• yams

According to the Institute of Medicine, a daily in-
take of 3-6 mg of beta carotene will keep the blood level
within the range associated with a lower risk for chronic
diseases. The recommended daily diet of five or more
servings of fruits and vegetables provides 3-6 mg of beta
carotene (if carrots, sweet potatoes, papaya, apricots or
other very high carotenoid food is used, the RDA can be
met in a single serving). In contrast, the average Ameri-
can diet contains 1.3-2. 9 mg daily. Vegetarians may have
twice as much beta carotene in their blood as compared
to non- vegetarians, because they generally consume a lot
more greens and fruits.

Beta carotene in food is found within an oil or a ma-
trix of sugars and proteins; and, therefore, the absorption of
beta carotene by the body varies greatly. The elderly, and
those with bad digestion and liver trouble may be at risk
for poor absorption from an adequate beta carotene diet.

Animal sources of vitamin A are more easily ab-
sorbed than plant sources of beta carotene, particularly if
the vegetables and fruits are eaten raw or whole. Al-
though beta carotene can be converted to vitamin A in
the body, it has its own unique physiological functions
and beta carotene and vitamin A are not totally identical
in the health benefits they deliver. So it is good to eat
sources of both. While supplementation is helpful to
those who have trouble absorbing adequate beta
carotene, getting all or some beta carotene through food
sources rather than supplements alone is by far the best.
This is substantiated by research showing there are many
beneficial carotenoids in foods, and that they may also
work together synergistically to optimize health.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Supplemental beta carotene

Beta carotene supplements are inexpensive and
readily available over-the-counter. They are available as
pills, powders, and oils and they vary greatly in potency.
Some supplements contain a mixture of carotenoids.
There is a major problem with shelf life stability for beta
carotene, as it “oxidizes” quickly when in pure form.
When buying a supplement of it, shelf life stability or the
presence of such stabalizers as vitamin E can guarantee
biological activity of the capsule.

Supplemental intake of beta carotene probably
should not exceed 3-15 mg per day. Common prepara-
tion of supplemental beta carotene include:

• 30- or 60-mg capsules

• 5,000-, 10,000-, or 25,000-IU capsules

• 10,000- or 25,000-IU tablets

A typical dosage of beta carotene for treating cancer
is 75,000-150,000 IU daily. Absorption of beta carotene
in nutritional supplements can be 70% or more. There is
no established maximum daily intake for beta carotene.

Some common beta carotene nutritional supple-
ments include:

• A-Caro-25

• B-Caro-T

• Biotene

• Caroguard

• Caro-Plete

• Dry Beta Carotene

• Lumitene

• Marine Carotene

• Mega Carotene

• Oceanic Beta Carotene

• Superbeta Carotene

• Ultra Beta Carotene

Manufacturers often supplement food with beta
carotene. One study showed that bakery products en-
riched with beta carotene increased beta carotene levels
in the blood.

Precautions

Antioxidants such as beta carotene often work to-
gether with other antioxidants and an excess or deficien-
cy of one can inhibit the other. The Food and Nutrition
Board of the Institute of Medicine does not recommend
beta carotene supplementation except in cases of vitamin
A deficiency.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Pregnant and nursing mothers should limit their in-
take of supplemental beta carotene to 6 mg per day or less.

Side effects

Even long-term high-dosage use of supplemental
beta carotene appears to be non-toxic. Daily doses of 30
mg or more over a long period may cause carotenosis
(carotenodermia), a yellowing of the skin, which is
harmless and reversible. In contrast, very high daily
doses of vitamin A are very dangerous and damage the
liver and other organs, as well as provoke hair loss).

Interactions

Drugs and other substances that may interfere with
beta-carotene absorption include:

• Cholestyramine

• Colestipol

• mineral oil

• Olestra

• Orlistat

• pectin

The absorption of luteine, another carotenoid an-
tioxidant, may be reduced if taken in conjunction with
beta carotene.

Resources

BOOKS

American Institute for Cancer Research. Nutrition and Cancer
Prevention: New Insights into the Role of Phytochemicals.
New York: Kluwer Academic/Plenum Publishers, 2001.
Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium,
and Carotenoids. Washington: National Academy Press,
2000 .

PDR for Nutritional Supplements. Montvale, NJ: Thomson
PDR, 2001.

PERIODICALS

Baron, J. A., et al. “Neoplastic and Antineoplastic Effects of
Beta-Carotene on Colorectal Adenoma Recurrence: Re-
sults of a Randomized Trial.” Journal of the National
Cancer Institute 95 (2003): 717-22.

Bendich, Adrianne. “From 1989 to 2001: What Have We Learned
about the "Biological Actions of Beta-carotene?’” Journal of
Nutrition 134, no. 1 (January 2004): 125S-130S.
“Disheartening Study.” Better Nutrition 65, no. 9 (September
2003): 32.

Heinrich, U., et al. “Supplementation with Beta-carotene or a
Similar Amount of Mixed Carotenoids Protects Humans
from UV-induced Erythema.” Alternative Medicine Re-
view 8, no. 2 (May 2003): 202-203.

"Incidence and Mortality Following Alpha-tocopherol and
Beta-carotene Supplementation: A Postintervention Fol-

207

Beta carotene

Beta hydroxy

KEY TERMS

Alpha-tocopherol — An antioxidant derivative of
vitamin E that stabilizes cell membranes.

Antioxidant — A substance that prevents oxidation,
such as cellular damage caused by free radicals.

Carotenoid — A large class of red and yellow pig-
ments found in some plants and in animal fat.

Carotenosis (carotenodermia, carotenemia) — A

yellowish pigmentation of the skin caused by high
levels of carotene in the blood.

Cholesterol — An important sterol that is deposited
on blood vessel walls in arteriolosclerosis.

Daily value (DV) — The percentage of the RDA of a
nutrient that is present in a food or supplement.
Epithelium — Layers of cells covering internal and
external body surfaces.

Free radical — An atom or compound with an un-
paired electron; oxygen free radicals can damage
cells and cell constituents.

Immune system — The body system that protects
against foreign pathogens and abnormal cells.

International unit (IU) — A widely accepted defin-
ition that is used to quantify a given substance.
Macular degeneratio. — The progressive deteriora-
tion of the macula — the light-sensitive cells of the
central retina of the eye.

Provitamin A — A carotenoid, such as beta
carotene, that can be converted into vitamin A in
the liver.

Recommended dietary allowance (RDA) — The av-
erage daily dietary intake of a nutrient that is suffi-
cient to meet the nutritional requirements of
97-98% of healthy individuals of a given age and
gender.

Retinol equivalent (RE) — 1 pg of all -trans retinol
(vitamin A), 6 pg of all -trans beta carotene.
Vitamin A (retinol). — An essential nutrient for vi-
sion that is obtained from animal products or
made in the liver from carotenoids such as beta
carotene.

low-up.” Journal of the American Medical Association
290. no. 4 (July 23, 2003): 476-85.

Quilez, Joan, et al. ‘‘Bakery Products Enriched with Phytos-
terol esters, [Alpha] -Tocopherol and [Beta]-Carotene De-
crease Plasma LDL-Cholesterol and Maintain Plasma
[Beta]-Carotene Concentrations in Normocholesterolemic

208

Men and Women.” Journal of Nutrition 133. no. 10 (Octo-
ber 2003): 3103.

Russell, R. M., et al. “The Enigma of Beta-Carotene in Car-
cinogenesis: What Can Be Learned From Animal Stud-
ies.” Journal of Nutrition 134, no. 1 (2004): 262S-268S.

“What’s Up Doc? Getting to the Root of Carrots.” Environmen-
tal Nutrition 26, no. 9 (September 2003): 8.

“The Word: Sweet Potato.” New Scientist 179, no. 2402 (July
5, 2003): 51.

OTHER

“Beta Carotene.” Making Treatment Decisions. American Cancer
Society. 2000 [cited May 4, 2004]. <http://www.cancer.
org/docroot/ETO/content/ETO_5_3X_Beta_Carotene.asp
?sitearea=ETO>.

Beta Carotene. Mayo Clinic. May 10, 2002 [cited May 4,
2004], <http://www.mayoclinic.com/invoke.cfm7objec-
tid=DFE6CA61-7BE5-45E0-86BFD9009E27BAE2>.

Task Force Finds Little Evidence to Support Use of Vitamin
Supplements to Prevent Cancer or Heart Disease. Agency
for Healthcare Research and Quality. June 30, 2003 [cited
May 4, 2004]. <http://www.ahrq.gov/news/press/pr2003/
vitapr.htm>.

Vitamin A and Carotenoids. Office of Dietary Supplements,
National Institutes of Health. October 6, 2003 [cited May
4, 2004], <http://www.cc.nih.gov/ccc/supplements/vita.
html>.

Margaret Alic

Beta hydroxy

Description

Beta hydroxy acids are a group of acids whose skin
treatment properties are being rediscovered. Developed
long ago for acne treatment, salicylic acid, benzoic acid,
butyric acid and other less well known acids have been
recently reclassified as beta hydroxy acids (BHAs) or
beta hydroxys.

BHAs are exfoliants, which means that they cause
the top layers of the skin to exfoliate or peel. Exfoliation
leaves behind fresh skin that is also smoother and softer
than before. Beta hydroxys work by speeding up the
turnover of skin cells. They dissolve the glue that holds
dead skin cells in the top layers, allowing the fresh cells
beneath to emerge. Chemical exfoliation with beta hy-
droxys peels away a variety of such age-related skin
problems as wrinkles, acne, age spots, blemishes, and
skin unevenness. Used on a regular basis at a much
lower concentration as cleansers or acne treatments,
BHAs refresh the skin and clear away the dirt and oils
that often cause acne eruptions. In addition to cosmetic

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

applications, these chemicals also are used as treatments
for a variety of skin disorders, including psoriasis, seb-
orrhea, dandruff, and warts.

BHAs are found in many skin care products. They
are also found naturally in fresh fruit (berries, pineapple,
papaya, etc.), milk and yogurt, wintergreen leaves,
sweet birch, and some other plants.

Structurally, BHAs appear to be very similar to an-
other group of chemicals used in skin care products, the
alpha hydroxy acids or AHAs. These two groups of
chemicals have similar activities as well; both are skin
exfoliants. BHAs, however, are believed to be less irritat-
ing to the skin than AHAs. They are also more effective
in preventing acne eruptions and smoothing the skin.

General use

Skin cleansing

Many skin cleansers today contain BHAs. BHAs are
effective because they help remove excess oil from the
face. They can, however, remove oil only on the surface
and cannot affect oil production under the skin. To help
maintain healthy skin, these cleansers should be used once
or twice a week to improve skin tone and texture. BHA-
containing preparations should be left on the face for a
short time only and rinsed off with generous amounts of
water. Because the skin is more sensitive to sunlight after
the use of products containing BHAs, users should apply
sunscreens and avoid prolonged sun exposure.

Wrinkles and age spots

Wrinkles are signs of the normal aging process.
Over the years, the skin becomes thinner, drier and less
elastic as its collagen and elastin fibers gradually lose
their elasticity. To improve the appearance of the skin
and to correct minor blemishes and uneveness, some
people have chemical peels with hydroxy acids. Chemi-
cal peels have become one of the most popular methods
for removing wrinkles. This process uses concentrated
preparations of BHAs, AHAs, or combinations of both to
remove the top layer of skin. The chemical peel allows a
newer layer of skin to replace the older layer. Some fine
lines and wrinkles may also be removed.

Because of potential scarring and other severe ad-
verse reactions, chemical peels are done by a profession-
al, usually a board-certified dermatologist or a licensed
estheticist (skin care specialist).

For best results, chemical peels are often used in combi-
nation with such other anti- wrinkle treatments as collagen or
fat implants or laser surgery. For relatively young people, a
chemical peel with BHA often provides satisfactory results.
Those over 40 sometimes choose to have collagen or fat im-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

plants together with the peel. Some older patients may have
both a chemical peel and a special kind of laser surgery
called laser resurfacing. While chemical peels can remove
some fine wrinkle lines, laser resurfacing is a more powerful
tool. It can remove deeper wrinkles and skin imperfections.

Acne therapy

Acne is a skin disorder caused by excessive produc-
tion of oil under the uppermost layers of skin. When the
oil cannot pass through the hair follicles, the pores under
the skin are plugged up, trapping the oil and dead skin
cells underneath the skin. These plugged pores become
fertile breeding grounds for a type of bacterium called
Propionibacterium acnes, sometimes called the acne
bacillus, to grow inside the pore, causing irritation, in-
flammation, and in due time, pimples.

Because it is an effective cleanser, a 1% solution of
salicylic acid, which is a BHA, can enter the pores and
help to remove excess oil, dirt, and dead skin cells. It re-
duces skin breakouts by preventing the buildup of dead
skin cells associated with acne formation. Beta hydroxy
acids, including salicylic acid, are good treatments for
acne because they are relatively mild. Because they are
applied topically, they do not cause systemic side effects
as oral antibiotics sometimes do. In addition, they are es-
pecially appropriate for the treatment of acne because
they have anti-inflammatory properties. BHAs, however,
do not have the antimicrobial properties of such topical
medications as benzyl peroxide.

Psoriasis

Psoriasis is a chronic skin condition requiring life-
long treatment with topical lotions and creams, pho-
totherapy (using radiation or ultraviolet light), or med-
ications taken by mouth. Salicylic acid can be used to
treat psoriasis. Salicylic acid facilitates the removal of
scaly skin. In so doing, it helps moisturizers and other
topical medications for psoriasis work more effectively.

Warts

Salicylic acid is also an effective and mild treatment
for warts and plantar warts. Patients should wash and dry
the area around the wart thoroughly before applying the
product. Then they should apply a thin film of salicylic acid
over each wart and allow it to dry. The product should be
applied once or twice a day. Salicylic acid acts slowly and
may take as long as 12 weeks before one can see results.

Other uses

The anti-inflammatory properties of BHAs are use-
ful in treating such other skin conditions as dandruff or
seborrheic dermatitis.

209

Beta hydroxy

Preparations

Salicylic acid is often found in many over-the-
counter skin care products such as soaps, cleansers, acne
medications, and anti-wrinkle creams. These products,
however, contain only 2% of salicylic acid. This concen-
tration is strong enough for exfoliation but not for chem-
ical peel treatment.

Chemical peel preparations contain very high con-
centrations (up to 30%) of beta hydroxy acids in combi-
nation with alpha hydroxy acids. Because of the poten-
tial for scarring and other severe adverse reactions, these
prescription-strength products are not sold to the general
public. They are available only to licensed dermatolo-
gists or estheticians.

BHAs can also be found in certain fruits and vegeta-
bles. For example, thin layers of papaya can be applied
on the face and allowed to remain for a while. Papaya
pulp helps soften the skin and decrease its unevenness. It
is most beneficial to dry, sun-damaged skin, although it
may also cause allergic reactions in some sensitive peo-
ple. Pineapple is another natural product that contains
beta hydroxy acid. Pineapple can be put into a blender or
juicer to obtain fresh juice. The juice can be applied to
the skin; again, however, it may cause allergic reactions.

Precautions

People who use skin care products containing BHAs
should be aware of the following considerations and side
effects:

• Increased sensitivity to sunlight. Exfoliated skin is very
tender and sensitive to sunlight. Studies have shown
that skin treated with these exfoliants has twice the sun
damage compared to untreated skin. Therefore, it is im-
portant to use suncreen and avoid direct exposure to the
sun when using products containing BHAs.

• Sensitization to other products. The use of salicylic
acid sometimes sensitizes the skin to other cosmetics
and causes redness and irritation. In other to avoid skin
sensitization, it is best to use only mild cleansers and
wait at least 10-30 minutes before using another cos-
metic or skin care product. Another way to avoid skin
sensitization is to use the BHA product every other day
instead of daily.

• Stinging. Salicylic acid can produce a stinging sensa-
tion when first applied. That is because it is a mild skin
irritant. Products containing salicylic acid should not
be applied on raw or abraded skin, as they may cause
redness and intense itching.

•Allergic reactions. Some salicylic acid products can
provoke hypersensitivity reactions. Any products that

210

KEY TERMS

Collagen — A fibrous tissue found in bones, con-
nective tissue, and cartilage.

Elastin — A yellow fibrous protein that is the basic
component of elastic connective tissue.

Exfoliate — To remove or peel off flakes or layers of
skin.

Plantar warts — Warts located on the sole of the
foot.

cause skin to burn, sting, redden, or break out should be
discontinued immediately.

• Blotchy skin. Sometimes BHA chemical peels cause
scarring and discoloration of some parts of the skin.
This occurs most often with the more concentrated
BHA products. Scarring and blotchy skin also tend to
occur more frequently in people with darker skin.

• Dry skin. A person with dry skin should not use BHA
cleansers too frequently (more than once a week) be-
cause they tend to dry the skin even further.

• Eye irritation. Skin care products containing salicylic
acid tend to cause the eyes to redden and water. Avoid
applying these cleansers, cream or lotion too close to
the eyes.

Side effects

Patients should stop using the product and contact
their doctors or pharmacists for advice if the following
adverse effects occur:

• dry skin

• eye irritation

• allergic reactions

• skin irritation

Interactions

Because salicylic acid tends to sensitize the skin,
allow at least 10-30 minutes to elapse between the use of
products containing salicylic acid and applying cosmet-
ics or other skin care products.

Resources

BOOKS

Sarnoff, Deborah S., and Joan Swirsky. Beauty and the Beam:

Your Complete Guide to Cosmetic Laser Surgery. New

York: Quality Medical Publishing Inc., 1998.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Tourles, Stephanie. Naturally Healthy Skin: Tips and Techniques for
a Lifetime of Radiant Skin. Vermont, RI: StoreyBooks, 1999.

PERIODICALS

Flynn, T. C. and W. P. Coleman. “Topical revitalization of body
skin." J Eur Acad Dermatol Venereol (July 2000): 280 — 4.

Kligman, D. and A. M. Kligman. “Salicylic acid peels for the
treatment of photoaging.” Dermatol Surg (March
19981:325-8.

Kockaert, M. and M. Neumann. “Systemic and topical drugs
for aging skin.” J Drugs Dermatol (August 2003):435-41.

ORGANIZATIONS

American Academy of Dermatology. P.O. Box 4014. Schaum-
burg, IL 60168-4014. (888) 462-DERM. Fax: (847) 330-
8907. <http://www.aad.org>.

Samuel Uretsky, Pharm.D.

Betaine hydrochloride

Description

The digestive process takes place as food passes
through the gastrointestinal tract, which consists of the
mouth, stomach, small intestine, and large intestine. Betaine
hydrochloride (C 5 H 12 N0 2 C1) is a source of hydrochloric
acid, a naturally occurring stomach acid that helps break up
fats and proteins for further digestion in the small intestine.
Gastric (stomach) acid also aids in the absorption of nutri-
ents through the walls of the intestines into the blood.

Gastric acid also helps protect the gastrointestinal
tract from harmful bacteria. A normal level of gastric
acid in the stomach — 100,000-1,000,000 times more
acidic than water — is sufficient to destroy bacteria, but a
low level increases the likelihood and severity of certain
bacterial and parasitic intestinal infections. One study
showed that fasting people with normal gastric acid lev-
els in the stomach had almost no bacteria in the small in-
testine, while individuals with low levels of hydrochloric
acid had some bacterial colonization in the stomach.

Betaine hydrochloride is a synthesized chemical,
and is not obtained from any plant or animal source.
Gastric acid is produced by stomach cells, and is not
available from any food source. Occasionally, betaine
(C 5 H u N0 2 )is recommended to reduce blood levels of
homocysteine, which is associated with heart disease.
This form of betaine is different from betaine hydrochlo-
ride, and is available only with a doctor’s prescription.

General use

Some research suggests that individuals with a wide
variety of chronic disorders, such as allergies, asthma,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

and gallstones, do not produce adequate amounts of
stomach acid. Many people with rheumatoid arthritis
are deficient in stomach acid and other digestive factors.
Taking betaine hydrochloride with meals can aid in pro-
tein digestion and possibly reduce food sensitivities
through improved digestion.

Naturopaths have long held that low stomach acid is
a widespread problem that interferes with the digestion
and absorption of nutrients. Betaine hydrochloride is one
of the most common recommendations for this condi-
tion. It helps make some minerals and other nutrients
more absorbable, and may be especially helpful with nu-
tritional supplements, which are often taken in tablets or
capsules that may not be easily digested.

Based on naturopathic theories about the importance
of stomach acid, betaine hydrochloride has been recom-
mended for a wide variety of problems, including ane-
mia, asthma, atherosclerosis, diarrhea, excess Candida
yeast, food allergies, gallstones, hay fever and allergies,
inner ear infections, rheumatoid arthritis, and thyroid
conditions. Many naturopathic physicians also believe
that betaine hydrochloride can help conditions such as
ulcers, indigestion, and esophageal reflux (heartburn).
Conventional treatment for those conditions involves re-
ducing stomach acid; according to one theory, however,
lack of stomach acid leads to incomplete digestion of
proteins, which causes allergic reactions and other re-
sponses that lead to increased ulcer pain. In keeping
with this theory, some doctors might recommend animal-
derived pancreatic enzymes for patients experiencing al-
lergic reactions to food. Vegetarians may wish to take be-
taine hydrochloride as an alternative to pancreatic en-
zymes, since it is not an animal product. Individuals suf-
fering from allergies, ulcers, or heartburn should talk to
their doctors before using betaine hydrochloride.

Betaine hydrochloride may be used as a lipotropic.
Lipotropics aid in preventing the accumulation of fat in
the liver, and usually help in the detoxification of meta-
bolic wastes and toxins. They may be used to help with
weight loss.

Benefits of lipotropics

• Detoxification of the waste byproducts of protein syn-
thesis.

• Increasing resistance to disease by stimulating the thy-
mus gland.

• Stepping up production of lecithin in the liver, which
can lower cholesterol levels.

• Preventing plaque deposits in arteries.

• Preventing gallstone formation.

211

Betaine hydrochloride

Beta-methylbutyric acid

• Protecting against diabetic neuropathy, a condition in
which the cranial and spinal nerves, as well as the
nerves in the bladder and bowel, may be affected.

Betaine hydrochloride has been used as a source of
hydrochloric acid in the treatment of hypochlorhydria, a
condition in which an abnormally low amount of hy-
drochloric acid is in the stomach. It has been used in prepa-
rations for the treatment of liver disorders, hypokalaemia
(abnormally low levels of potassium in the blood), C0 2
production in double contrast radiography, and high homo-
cysteine. Betaine hydrochloride has also been used to treat
tic douloreux (a condition which involves spasmodic pain
along the course of a facial nerve), cystinuria (a hereditary
defect that results in recurrent kidney stone formation), and
vitiligo (a condition that is characterized by milky-white
patches on otherwise normal skin).

Preparations

Betaine hydrochloride (also called betaine HC1) is
typically taken in tablets or capsules of 5-10 grains (325-
650 mg)each with a meal that contains protein. Naturo-
pathic or nutritionally oriented physicians may make rec-
ommendations of such tablets based on their diagnoses.

Precautions

People with a history of ulcers, heartburn, or other
gastrointestinal symptoms should see a nutritionally ori-
ented doctor before taking betaine hydrochloride, and no
one should take more than 10 grains (650 mg) without a
physician’s recommendation. Large amounts of betaine
hydrochloride can burn the lining of the stomach. If a
burning sensation is experienced, betaine hydrochloride
should be immediately discontinued.

Side effects

Side effects are seldom seen, but betaine hydrochlo-
ride has not been through rigorous safety studies. Its safety,
especially for young children, pregnant or nursing women,
or those with severe liver or kidney disease, is not known.

Interactions

People taking nonsteroidal anti-inflammatory drugs
(NSAIDs), cortisone-like drugs, or other medications
that could cause peptic ulcers should not take betaine hy-
drochloride.

Resources

PERIODICALS

Challem, Jack. “Navigating the labyrinth: 30 things you need

to know about nutritional supplements.” Vegetarian Times

(January 1998), no. 245: 66-67 .

212

KEY TERMS

Cystinuria — Excess cystine, lysine, arginine, and
ornithine in urine due to defective transport sys-
tem of these acids in kidney and intestines.

Gastric acid — Also, stomach acid. Helps break up
fats and proteins for further digestion, aids in the
absorption of nutrients through the walls of the in-
testines into the blood, and helps protect the gas-
trointestinal tract from harmful bacteria.
Homocysteine — An amino acid in the blood, too
much of which is related to a higher risk of vascu-
lar disease.

Lipotropic — Substances that help prevent or cor-
rect excessive fat deposits in liver.

Gormley, James J. “Healthful weight loss includes L-carnitine,
chromium, and lipotropics.” Better Nutrition 58, no. 5: 40-
41.

OTHER

Personal Health Zone. “Betaine Hydrochloride.” [cited December
2000], <http://www.personalhealthzone.com/pg000106.html

GNC (General Nutrition Centers), [cited December
2000]. <http://www.gnc.com/wellness/natpharm/supp/
betaine_HCl-F.htm/ >

Melissa C. McDade

Beta-methylbutyric acid

Description

Beta-methylbutryic acid, technically known as,
“beta-hydroxy beta-methylbutyric acid,” or more com-
monly known as “HMB,” is a metabolite of the amino
acid leucine. Human muscles have a particularly high
concentration of leucine, so this amino acid is often bro-
ken down/utilized during strenuous exercise. HMB is
also found in grapefruit and catfish in trace quantities. It
was first found to be of use in agriculture as an additive to
help pigs, chickens, and other farm animals gain muscle
and lose fat. It was not until a research trial conducted by
the University of Iowa at Iowa City showed positive re-
sults that it caught attention as promising for human use.

The four-week double-blind study in 1995 involved
17 exercise-trained and 23 untrained males, divided into
two groups. One group took daily capsules containing 3

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

g of HMB, and the other took placebos. Everyone ob-
served an identical weight-training regimen three times a
week. Upon the trial’s completion, the group who took
the HMB demonstrated an average 3.1% increase in lean
muscle mass, as compared with 1.9% for those who took
the placebos. Also, the HMB group lost an average of
7.3% initial body fat, against 2.2% for the placebo
group. The men who took HMB were able to average 22
pounds more with the bench press than they did at the
beginning of the study. The men who did not, averaged a
14 pound increase. Thus, when taken as a supplement,
up to 3 g a day, HMB has been shown to increase lean
muscle mass and strength in athletes who use it during
weight training. Theories suggest that HMB possibly
suppresses protein breakdown that follows exercise that
is rigorous and of long-term duration.

The patent for HMB is held jointly by Iowa State
University and Vanderbilt University, which conducted
the first studies on the compound. Experimental and Ap-
plied Sciences, Inc. (EAS)of Golden, Colorado, was
originally licensed to market it. As of 2000, dozens of
companies have it available for sale through retail stores,
and commercial websites.

General use

By the Summer Olympics in Atlanta in 1996, the
publicity of the possible benefits of HMB had spread
among athletes. Because it was not a banned substance,
demand was heavy; it continues to remain popular
among athletes as a nutritional supplement. This is true
particularly for weight trainers, but has been reported as
useful for any athlete undergoing resistance training. It is
considered a “state-of-the-art” bodybuilding supplement,
and tends to show an increase of lean mass and strength
among those who use it. Studies have also shown that
HMB might also accelerate fat loss that occurs sec-
ondary to strenuous exercise. According to Wayne Hearn
in American Medical News in August of 1996, Dr. Naji
N. Abumrad, MD, originally with the Vanderbilt team,
began to conduct studies in 1996 that explored HMB’s
“potential use as an antiwasting agent that could benefit
AIDS and cancer patients and help maintain muscle
mass in the elderly.” This research remains as ongoing.

Preparations

HMB is available in both powder and capsule form,
with capsule form being the primary method of usage. In
2000, an average price for 250 mg capsules ran approxi-
mately $35-$55 depending on retailer and volume pur-
chased. Because HMB is a food supplement and not a
drug, it is not subject to Federal Drug Administration
(FDA) standards, and therefore has no minimum require -

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Leucine — An amino acid produced by the hydrol-
ysis of proteins by pancreatic enzymes during di-
gestion, and by putrefaction of nitrogenous organ-
ic matter.

ment recommendation. Tests have suggested that
dosages from 1.5-3 g a day are required to achieve de-
sired results.

Precautions

As a food supplement found in every cell of the
human body, it has no toxic effects, according to the re-
search conducted. Because no long-term studies had
been conducted on children, or pregnant or lactating
women, the supplement could not be recommended for
these groups. Thus, these groups of people should con-
sult a physician, and use HMB with caution.

Side effects

According to Abumrad, the only side effects discov-
ered have been positive ones. Yet the benefits of lower
cholesterol and blood pressure levels found to occur with
the use of the supplement, were also associated with the
intense exercise that seems to trigger HMB’s tissue -build-
ing effects. As Hearn reported, “That stands in stark con-
trast to the side effects of unprescribed steroid use by ath-
letes and bodybuilders, which has been linked to cancer,
heart disease, kidney and liver damage, and erratic mood
swings.” Studies were ongoing to determine what other
possible benefits or disadvantages HMB would prove to
be for the long-term period of usage. Physicians were
urged to add caution to their patients regarding this sup-
plement to be alert to any unforeseen complications. In
2000, various websites offer testimony for or against
usage. Those who recommend against it do so only in of-
fering that it did not appear to be of any use, and did not
provide them with the touted benefits.

Interactions

No known adverse reactions have yet been docu-
mented when HMB is taken with other drugs or food
supplements. It has been recommended for usage with
creatine monohydrate for intense training.

Resources

PERIODICALS

Antonio, Jose, Ph.D. Let’s Live 66, no. 6 (1998).

213

Beta-methylbutyric acid

Bhakti yoga

Antonio, Jose.Ph.D. Muscle & Fitness 58, no.5 (1997).

Hearn, Wayne. American Medical News 39, no. 31 (1996).
Available at: http://web4.infotrac.galegroup.com/itw.

Lee, In- Young and J.P.N. Rosazza. Archives of Microbiology
169, no. 3 (1998). Available at: http://link.springer~ny.
com/Unk/service/joumals/00203.

Maenz, David D. and Carmen M. Engele-Schaan. Journal of
Nutrition 126, no. 2 (1996). Available at: http://web4.
infotrac.galegroup.com/itw.

Mulgannon, Terry. Men’s Fitness 13, no. 6 (1997).

OTHER

Burke, Edmund R.,Ph.D. MotherNature.com News, http://
www.MotherNature.com/.

Jane Spear

Bhakti yoga

Definition

Bhakti yoga is one of six major branches of yoga, rep-
resenting the path of self-transcending love or complete
devotion to God or the divine. A practitioner of bhakti yoga
regards God as present in every person or sentient being.
Although bhakti yoga developed within a Hindu culture, it
can be practiced by members of Western religions, as it fo-
cuses the believer’s mind and heart on God as a supreme
Person rather than an impersonal Absolute. Unlike hatha
yoga, which is the form of yoga most familiar to Ameri-
cans, bhakti yoga does not place great emphasis on breath-
ing patterns or asanas (physical postures), but rather on
acts of worship, devotion, and service.

Origins

Bhakti yoga is thought by some to be the oldest
form of yoga, with its roots in the Vedas, or ancient
scriptures of India. Some of the hymns in the Vedas are
thought to be four thousand years old. Bhakti yoga did
not emerge as a distinctive form of yoga, however, until
about 500 B.c., the time of the composition of the Bha-
gavad-Gita, a Sanskrit work containing the teachings of
Krishna, one of the most beloved of Hindu deities.

Bhakti yoga eventually became the focus of a popu-
lar devotional movement in India known as the bhakti-
marga or “road of devotion.” This movement flourished
between 800 and 1100 A.D.. Around 900, devotees of Kr-
ishna who belonged to the bhakti-marga produced a
scripture known as the Bhagav ad-Pur ana, which con-
tains Krishna’s instructions to his worshipers. In one
passage from the Bhagav ad-Pur ana, Krishna praises

214

bhakti above all other paths to bliss. He is represented as
saying, “The wise person should abandon bad company
and associate with the virtuous, for the virtuous ones
sever the mind’s attachments [to worldly concerns] by
their utterances.. O greatly blessed devotee, these
blessed ones constantly tell my story, by listening to
which people are released from sin. Those who respect-
fully listen to, esteem, and recite my story become dedi-
cated to me and attain faith and devotion to me.”

Benefits

The chief benefit of bhakti yoga, from the perspec-
tive of its practitioners, is greater love for and closeness
to God, and to other people (and all beings) as reflections
of God. Although bhakti yoga is also beneficial to mental
and physical well-being, improved health is not the pri-
mary reason most adherents choose this form of yoga.

Description

The Hindu sacred texts list nine forms of bhakti
yoga:

• Sravana. Sravana is the Sanskrit term for listening to
poems or stories about God’s virtues and mighty deeds.
Sravana bhakti cannot be practiced in isolation, howev-
er; the devotee must hear the stories from a wise
teacher, and seek the companionship of holy people.

• Kirtana. Kirtana refers to singing or chanting God’s
praises. Ram Dass has said of this form of bhakti
“When you are in love with God, the very sound of the
Name brings great joy.”

• Smarana. Smarana is remembrance of God at all times,
or keeping God in the forefront of one’s consciousness.
In Christian terms, smarana is what the French monk
Brother Lawrence (1605-1691) meant by “the practice
of the presence of God.”

• Padasevana. This form of bhakti yoga expresses love to-
ward God through service to others, especially the sick.

• Archana. Archana refers to worship of God through
such external images as icons or religious pictures, or
through internal visualizations. The purpose of archana
is to purify the heart through love of God.

• Vandana. Vandana refers to prayer and prostration
(lying face downward on the ground with arms out-
stretched). This form of bhakti yoga is intended to curb
self-absorption and self-centeredness.

• Dasya. In dasya bhakti, the devotee regards him- or
herself as God’s slave or servant, carrying out God’s
commandments, meditating on the words of God, car-
ing for the sick and the poor, and helping to clean or re-
pair sacred buildings or places.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

• Sakha-bhava. This form of bhakti yoga is a cultivation
of friendship-love toward God — to love God as a mem-
ber of one's family or dearest friend, and delight in
companionship with God.

• Atma-nivedana. Atma-nivedana is complete self-offer-
ing or self- surrender to God. Unlike some other forms
of yoga, however, bhakti yoga does not teach that the
devotee completely loses his or her personal identity
through absorption into the divine. God is regarded as
infinitely greater than the human worshiper, even one at
the highest levels of spiritual attainment.

The nine types of bhakti yoga are not considered a
hierarchy in the sense that some are regarded as superior
to others in guiding people toward God. An Indian
teacher of bhakti yoga has said, “A devotee can take up
any of these paths and reach the highest state. The path
of bhakti is the easiest of all [types of yoga] and is not
very much against the nature of human inclinations. It
slowly and gradually takes the individual to the Supreme
without frustrating his [sic] human instincts.”

Preparations

The practice of bhakti yoga does not require any
special physical or emotional preparation. It is a good
idea, however, for Western readers to gather more in-
formation about a specific form of bhakti yoga that
may interest or attract them. This preparation is partic-
ularly important because the tendency of Western cul-
ture to separate intellect from feeling leads many peo-
ple to think of bhakti as sheer emotional fervor that
does not engage the mind, whereas many of the great
teachers of bhakti yoga were known for their wisdom
and mindfulness as well as intensity of devotion. Use-
ful resources for learning more about bhakti yoga in-
clude such periodicals as Yoga Journal and the various
organizations listed below.

Precautions

Bhakti yoga tends to attract persons of a strongly
emotional nature. There is some risk, however, of such
individuals remaining spiritually immature or joining
cult-like groups. The Hare Krishna movement, for exam-
ple, is an offshoot of one school of bhakti yoga, the
Gaudiya vaishnava tradition. Although some members of
the movement consider their participation meaningful,
others have left because they experienced it as repressive
and intolerant of other faiths.

Side effects

There are no known side effects associated with the
practice of bhakti yoga.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Research & general acceptance

A number of research studies have shown that such
spiritual and devotional practices as those associated
with bhakti yoga have positive effects on physical as
well as emotional health. The positive physical effects
include strengthening of the immune system, lowered
blood pressure, and improved ability to cope with chron-
ic pain. Chanting or hymn singing (kirtana) has been
shown to be particularly effective in pain management.

Several research studies published in early 2004 re-
port that all forms of yoga are becoming increasingly
popular among Americans over 40 — particularly women
and people living in urban areas — for general wellness as
well as back pain or other specific health problems. At
least 15 million adults in the United States have partici-
pated in yoga programs, according to a study conducted
at Harvard Medical School. Ninety percent of those con-
tacted by telephone in a research sample said that they
found yoga very or somewhat helpful. A survey of can-
cer patients in a supportive care program at Stanford Uni-
versity found that yoga and massage therapy were the
activities that drew the largest number of participants.

Training & certification

There are no international or nationwide licensing or
credentialing procedures for spiritual guides or teachers
of bhakti yoga. The web site of the American Yoga Asso-
ciation (AYA) does, however, include an article on “How
to Choose a Qualified Teacher.”

Resources

BOOKS

Dass, Ram. Journey of Awakening: A Meditator’s Guidebook .
New York: Bantam Books, 1978. Contains some prayers,
hymns, chants, and other suggestions for devotion drawn
from Christian and Jewish sources that can be used in the
practice of bhakti yoga.

Dossey, Larry, MD. Healing Beyond the Body: Medicine and
the Infinite Reach of the Mind . Boston: Shambhala Publi-
cations, Inc., 2001.

Feuerstein, Georg, and Stephan Bodian, eds. Living Yoga: A
Comprehensive Guide for Daily Life, Part III, “Cultivating
Love: Bhakti Yoga.” New York: Jeremy P. Tarcher/Perigee
Books, 1993.

Pelletier, Kenneth, MD> The Best Alternative Medicine, Chap-
ter 2, “Sound Mind, Sound Body.” New York: Simon &
Schuster, 2002.

Sivananda, Swami, and the Staff of the Sivananda Vedanta
Yoga Center. Yoga Mind and Body . New York: DK Pub-
lishing, 1998.

PERIODICALS

Rosenbaum, E., H. Gautier, P. Fobair, et al. “Cancer Supportive
Care, Improving the Quality of Life for Cancer Patients. A

215

Bhakti yoga

Bilberry

KEY TERMS

Asanas — Physical postures associated with the
practice of hatha yoga.

Sanskrit — The classical literary language of India.
It is considered the oldest living language of the
Indo-Aryan family.

Program Evaluation Report.” Supportive Care in Cancer
12 (May 2004): 293-301.

Saper. R. B., D. M. Eisenberg, R. B. Davis, et al. “Prevalence
and Patterns of Adult Yoga Use in the United States: Re-
sults of a National Survey.” Alternative Therapies in
Health and Medicine 10 (March-April 2004): 44-49.

Wolsko, P. M., D. M. Eisenberg. R. B. Davis, and R. S.
Phillips. “Use of Mind-Body Medical Therapies.” Journal
of General Internal Medicine 19 (January 2004): 43-50.

ORGANIZATIONS

American Yoga Association (AYA). P. O. Box 19986, Sarasota,
FL 34276. (941) 927-4977. Fax: (941) 921-9844. <http://
www.americanyogaassociation.org>.

Yoga Alliance. 122 West Lancaster Avenue, Suite 204, Reading,
PA 19607-1874. (610) 777-7793. Fax: (610) 777-0556.
<http://www.yogaalliance.org>.

Yoga Research and Education Center (YREC). P. O. Box 426,
Manton, CA 96059. (530) 474-5700. <http://www.yrec.
org>.

OTHER

Yoga.com Staff. “History of Bhakti Yoga.” [cited May 23, 2004].
<http : //w ww.yoga.com/ydc/enlighten/enlighten_document .
asp>.

Rebecca Frey, PhD

Bilberry

Description

Bilberry ( Vaccinium myrtillus ) is a European berry
shrub that is related to the blueberry, huckleberry, and
bearberry plants that grow in the United States. Bilberry
is a small, wild, perennial shrub that grows throughout
Europe and is now cultivated from the Far East to the
United States. The shrub yields large amounts of small,
darkish blue berries. Besides their medicinal use, they
are often eaten fresh or made into jams and preserves.
The leaves of the plant are used medicinally as well, but
to a lesser extent than the berries. The qualities of the
herb are sour, astringent, cold, and drying.

216

Bilberry has been used by European herbalists for
centuries. In Elizabethan times, bilberries were mixed
with honey and made into a syrup called rob that was
prescribed for diarrhea and stomach problems. The
berries were also used for infections, scurvy, and kidney
stones. The leaves of the plant were used as a folk reme-
dy for diabetes. Bilberry is most famous, though, for its
long use as a medicine for eye and vision problems. Leg-
end has it that during World War II, British and Ameri-
can pilots discovered that eating bilberry jam before
night missions greatly improved their night vision. Bil-
berries then became a staple for Air Force pilots. Since
then, extensive research in Europe has shown that bilber-
ries contain specific compounds that have beneficial ef-
fects on the eyes and circulatory system. In France, bil-
berries have been prescribed since 1945 for diabetic
retinopathy, a major cause of blindness in diabetics.

Bilberries are high in substances called flavonoids,
which are found in many fruits, vegetables, grains, beans,
peas, and are particularly abundant in citrus fruits and
berries. Flavonoids are chemicals technically known as
polyphenols. Flavonoids have antioxidant and disease-
fighting properties. Antioxidants are substances that help
cells in the body resist and repair damage. The flavonoids
found in bilberry provide the blue color of the berry. The
bilberry flavonoids are called anthocyano sides, which
were found to be the main active ingredients.

Bilberry flavonoids can increase certain enzymes
and substances in the eyes that are crucial to good vision
and eye function. Furthermore, anthocyanosides can in-
crease circulation in the blood vessels in the eyes, and
help these blood vessels repair and protect themselves.
Specifically, research has shown that anthocyanosides
help stabilize and protect a protein called collagen,
which is a basic building block of veins, arteries, capil-
laries, and connective tissue. Particularly, anthocyano-
sides seem to work favorably in the tissues found in the
retina, the back of the eye where major functions of vi-
sion take place. The retina is composed of millions of
tiny nerve cells and blood vessels, which anthocyano-
sides can help support. Bilberry is a common treatment
for many varieties of retinopathy, a disorder in which the
intricate blood and nerve vessels in the retina are dam-
aged. Retinopathy particularly affects people with dia-
betes, high blood pressure, and sickle cell anemia.

Many studies have documented bilberry’s useful-
ness as a medicinal herb. One study demonstrated that
bilberry extract used with Vitamin E prevented the pro-
gression of cataracts in 48 of 50 patients with cataract
formations. In animal studies, bilberry reduced and sta-
bilized blood sugar levels. In an Italian study, bilberry’s
flavonoids lowered cholesterol levels in the blood and
improved circulation.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

General use

Bilberry is most commonly used as a component of
treatment for various vision and eye disorders, including
glaucoma, cataracts, and macular degeneration. However,
people with glaucoma should be monitored by an eye doctor
regularly, and those with acute glaucoma should not depend
on bilberry alone to protect their vision. They can use bilber-
ry along with other emergency medical treatments. Bilberry
is included in the treatments for many types of retinopathy
and is also used for eye fatigue, poor night vision, and near-
sightedness. It can be used as a preventative measure for
glaucoma and cataracts, and to help those who require pre-
cise night vision like cab drivers and pilots. Bilberry’s circu-
lation improving and cholesterol lowering qualities make it
useful in the treatment of varicose veins and atherosclero-
sis. it is also occasionally prescribed for arthritis.

Preparations

Fresh bilberries can be eaten like blueberries, al-
though they are difficult to find outside of Europe. Two
to four ounce servings of the fresh fruit can be eaten
three times a day. One to two cups each day is a good
dose. Dried bilberries are sometimes available in herb or
organic health food stores, and two or three small hand-
fuls can be eaten per day. However, dried berries are
likely to contain only a small amount of the flavonoids.

Bilberry supplements are widely available in health
food stores. They can be purchased as capsules and liq-
uid extracts. A high-quality supplement may contain a
standardized formula of up to 25% anthocyanocides. The
dosage recommended with this percentage of active in-
gredients is 80-160 mg taken three times daily. Bilberry
supplements may be taken with food or on an empty
stomach. Bilberry jam and syrup may also be used.

For eye and circulatory problems, bilberry can be
taken with ginkgo to increase its beneficial effects. Vita-
mins A, C and E may also enhance bilberry’s healing ef-
fects in the eye. Some suggestions have been made that
other flavonoid-containing supplements, such as pine
bark extract and grape seed extract, can possibly en-
hance bilberry’s healing properties.

Precautions

Bilberry may be used as prevention and herbal sup-
port for eye conditions, but should not replace medical
care. Consumers with vision problems should be thor-
oughly and immediately examined by an ophthalmologist
(eye specialist) before any treatment or remedy is used.

Side effects

Bilberries can be taken in large doses without any
side effects. However, bilberry leaves shouldn’t be taken

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Atherosclerosis — Disease in which the arteries
and circulation are impaired from hardening and
clogging, often from high cholesterol levels.

Cataracts — Eye condition in which the lenses
harden and lose their clarity.

Glaucoma — Eye disease that can cause blindness;
characterized by excess fluid between the iris and
cornea of the eye.

Macular degeneration — Disease in which the
macula, the part of the retina responsible for pre-
cise vision, deteriorates.

in large doses or over long periods of time because they

are toxic.

Resources

BOOKS

Keville, Kathi. Herbs: An Illustrated Encyclopedia. New York:
Friedman/Fairfax, 1994.

Mayell, Mark. Off-the -Shelf Natural Health. New York: Ban-
tam, 1995.

PERIODICALS

HerbalGram (a quarterly journal of the American Botanical
Council and Herb Research Foundation) RO. Box 144345,
Austin, TX 78714-4345, (800) 373-7105. <http://www.
herbalgram.org . >

ORGANIZATIONS

Herb Research Foundation. 1007 Pearl Street, Boulder, CO
80302.

OTHER

Dietary Supplement Quality Initiative, <http://www.dsqi.org.>

Douglas Dupler

Binge eating disorder

Definition

Binge eating disorder (BED) is characterized by a
loss of control over eating behaviors. The binge eater
consumes unnaturally large amounts of food in a short
time period, but unlike a bulimic, doesn’t regularly en-
gage in any inappropriate weight-reducing behaviors
(like excessive exercise, vomiting, taking laxatives)
after the binge episodes.

217

Binge eating disorder

Description

About three percent of women and one-tenth as
many men have duffered from either bulimia or binge
eating disorder at some time in their lives. BED typically
strikes individuals between their adolescent years and
their early 20s. Because of the nature of the disorder,
most BED patients are overweight or obese. Studies of
weight loss programs have shown that an average of
30% of individuals enrolling in these programs report
binge eating behavior. Binge eating in milder forms is
even more common, as are attempts to compensate for
the binges.

Causes & symptoms

Binge eating episodes may act as a psychological
release for excessive emotional stress. Other circum-
stances that may predispose an individual to BED in-
clude heredity and mood disorders, such as major de-
pression. BED patients are also more likely to have an
additional diagnosis of impulsive behaviors (for exam-
ple, compulsive shopping), post-traumatic stress disor-
der (PTSD), panic disorder, or personality disorders.
More than half also have a history of major depression.
In 2002, the American Psychiatric Association was con-
sidering including BED as a psychiatric diagnosis.

individuals who develop BED often come from fam-
ilies who put an unnatural emphasis on the importance of
food. For example, these families may use food as a
source of comfort in times of emotional distress. As chil-
dren, BED patients may have been taught to clean their
plates regardless of their appetite, or to be a good girl or
boy and finish all of the meal. Cultural attitudes towards
beauty and thinness may also be a factor in BED.

During binge episodes, BED patients experience a
definite sense of lost control over their eating. They eat
quickly and to the point of discomfort, even if they aren’t
hungry. They typically binge alone two or more times a
week, and often feel depressed and guilty when the
episode is over.

Diagnosis

BED is usually diagnosed and treated by a psychia-
trist and/or a psychologist, in addition to an interview
with the patient, personality and behavioral inventories,
such as the Minnesota Multiphasic Personality Inventory
(MMPI), may be administered as part of the assessment
process. One of several clinical inventories, or scales,
may also be used to assess depressive symptoms, includ-
ing the Elamilton Depression Scale (HAM-D) or Beck
Depression Inventory (BDI). These tests may be admin-
istered in an outpatient or hospital setting.

218

Treatment

Many BED individuals binge after long periods of
excessive dieting; therapy helps normalize this pattern.
The initial goal of BED treatment is to teach the patient
to gain control over his or her eating behavior by focus-
ing on eating regular meals and avoiding snacking. Cog-
nitive behavioral therapy, group therapy, or interper-
sonal psychotherapy may be used to uncover the emo-
tional motives, distorted thinking, and behavioral pat-
terns behind the binge eating. The overweight BED
patient may be placed on a moderate exercise program
and a nutritionist may be consulted to educate the patient
on healthy food choices and strategies for weight loss.

Initial treatment may focus on curbing the depression
that is a characteristic feature of BED. Recommended
herbal remedies to ease the symptoms of depression may
include damiana ( Turnera diffusa ), ginseng (Panax gin-
seng), kola ( Cola nitida), lady’s slipper ( Cypripedium cal-
ceolus), lavender ( Lavandula angustifolia), lime blossom
(Tilia x vulgaris), oats ( Avena sativa), rosemary ( Rosmar-
inus officinalis), skullcap ( Scutellaria laterifolia), St.
John’s wort ( Hypericum perforatum), valerian ( Valeri-
ana officinalis), and vervain ( Verbena officinalis).

Binge-eating episodes that appear to be triggered by
stress may be curbed by educating the patient in relaxation
exercises and techniques, including aromatherapy, breath-
ing exercises, biofeedback, music therapy, yoga, and mas-
sage. Herbs known as adaptogens may also be prescribed by
an herbalist or holistic healthcare professional. These herbs
are thought to promote adaptability to stress, and include
Siberian ginseng ( Eleutherococcus senticosus), ginseng
( Panax ginseng), wild yam ( Dioscorea villosa), borage (Bor-
ago officinalis), licorice ( Glycyrrhiza glabra), chamomile
0 Chamaemelum nobile), and nettles ( Urtica dioica). Tonics
of skullcap ( Scutellaria lateriafolia), and oats ( Avena sativa),
may also be recommended to ease anxiety.

Allopathic treatment

Treatment with antidepressants may be prescribed
for BED patients. Selective serotonin reuptake inhibitors
(such as Prozac) are usually preferred because they offer
fewer side effects. However, clinical studies don’t show
much effectiveness for use of antidepressants in treating
BED. Psychotherapy shows better results. Once the
binge eating behavior is curbed and depressive symp-
toms are controlled, the physical symptoms of the disor-
der can be addressed.

Expected results

The poor dietary habits and obesity that are sympto-
matic of BED can lead to serious health problems, such as

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Bulimia — An eating disorder characterized by
binge eating and then excessive behavior (such as
vomiting, misusing laxatives, or exercising exces-
sively) to rid the body of the food eaten.

Cognitive behavioral therapy — A therapy that fo-
cuses on changing negative behavior in order to
alter the attitudes or harmful thinking patterns that
cause the behavior.

high blood pressure, heart attacks, and diabetes, if left
unchecked. BED is a chronic condition that requires ongo-
ing medical and psychological management. To bring
long-term relief to the BED patient, it is critical to address
the underlying psychological causes behind binge eating
behaviors. It appears that up to 50% of BED patients will
stop bingeing with cognitive behavioral therapy.

Resources

BOOKS

Abraham, Suzanne and Derek Llewellyn-Jones. Eating Disor-
ders: The Facts. 4th ed. Oxford: Oxford University Press,
1997.

American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders, 4th ed. Washington, DC:
American Psychiatric Press, Inc., 1994.

Siegel, Michele, Judith Brisman, and Margot Weinshel. Surviv-
ing an Eating Disorder: Strategies for Family and
Friends, 2nd ed. New York: Harper Perennial, 1997.

PERIODICALS

Brewerton, Timothy D. “Binge Eating Disorder: Recognition,
Diagnosis, and Treatment.” Medscape Mental Health 2,
no. 5 (1997). http://www.medscape.com.

"Treatment of Bulimia and Binge Eating.” Harvard Mental
Health Letter (July 2002).

Tufts University. "Binge Eating Disorder Comes Out of the
Closet: Experts Say Leading Obesity Factor Has Long
Been Overlooked.” Tufts University Diet & Nutrition Let-
ter 14, no. 1 1 (January 1997): 4-5.

ORGANIZATIONS

American Psychiatric Association ( APA). Office of Public Af-
fairs. 1400 K Street NW, Washington, DC 20005. (202)
682-6119. http://www.psych.org/.

American Psychological Association (APA). Office of Public
Affairs. 750 First St. NE, Washington, DC 20002-4242.
(202) 336-5700. http://www.apa.org/.

Eating Disorders Awareness and Prevention. 603 Stewart St.,
Suite 803, Seattle, WA 98101. (800) 931-2237. http://
www.edap.org

National Eating Disorders Organization (NEDO). 6655 South
Yale Ave., Tulsa, OK 74136. (918) 481-4044.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Overeaters Anonymous World Service Office. 6075 Zenith Ct.
NE, Rio Rancho, NM 87124. (505) 891-2664. http://www.
overeatersanonymous.org/.

Paula Ford-Martin
Teresa G. Odle

Biocytin see Brewer's yeast

Biofeedback

Definition

Biofeedback, or applied psychophysiological feed-
back, is a patient-guided treatment that teaches an individ-
ual to control muscle tension, pain, body temperature, brain
waves, and other bodily functions and processes through
relaxation, visualization, and other cognitive control tech-
niques. The name biofeedback refers to the biological sig-
nals that are fed back, or returned, to the patient in order for
the patient to develop techniques of manipulating them.

Origins

In 1961, Neal Miller, an experimental psychologist,
suggested that autonomic nervous system responses (for in-
stance, heart rate, blood pressure, gastrointestinal activity,
regional blood flow) could be under voluntary control. As a
result of his experiments, he showed that such autonomic
processes were controllable. This work led to the creation
of biofeedback therapy. Willer’s work was expanded by
other researchers. Thereafter, research performed in the
1970s by UCLA researcher Dr. Barry Sterman established
that both cats and monkeys could be trained to control their
brain wave patterns. Sterman then used his research tech-
niques on human patients with epilepsy, where he was able
to reduce seizures by 60% with the use of biofeedback tech-
niques. Throughout the 1970s, other researchers published
reports of their use of biofeedback in the treatment of car-
diac arrhythmias, headaches, Raynaud’s syndrome, and
excess stomach acid, and as a tool for teaching deep relax-
ation. Since the early work of Miller and Sterman, biofeed-
back has developed into a front-line behavioral treatment
for an even wider range of disorders and symptoms.

Benefits

Biofeedback has been used to successfully treat a
number of disorders and their symptoms, including tem-
promandibular joint disorder (TMJ), chronic pain, irrita-
ble bowel syndrome (IBS), Raynaud’s syndrome,
epilepsy, attention-deficit hyperactivity disorder

219

Biofeedback

A patient undergoing biofeedback therapy. (Photo Re-
searchers, Inc. Reproduced by permission.)

(ADHD), migraine headaches, anxiety, depression,
traumatic brain injury, and sleep disorders.

Illnesses that may be triggered at least in part by
stress are also targeted by biofeedback therapy. Certain
types of headaches, high blood pressure, bruxism (teeth
grinding), post-traumatic stress disorder, eating disor-
ders, substance abuse, and some anxiety disorders may
be treated successfully by teaching patients the ability to
relax and release both muscle and mental tension.
Biofeedback is often just one part of a comprehensive
treatment program for some of these disorders.

NASA has used biofeedback techniques to treat astro-
nauts who suffer from severe space sickness, during which
the autonomic nervous system is disrupted. Scientists at the
University of Tennessee have adapted these techniques to
treat individuals suffering from severe nausea and vomiting
that is also rooted in autonomic nervous system dysfunction.

Recent research also indicates that biofeedback may
be a useful tool in helping patients with urinary inconti-
nence regain bladder control. Individuals learning pelvic-
floor muscle strengthening exercises can gain better con-
trol over these muscles by using biofeedback. Sensors are
placed on the muscles to train the patient where they are
and when proper contractions are taking place.

Description

During biofeedback, special sensors are placed on
the body. These sensors measure the bodily function that

220

is causing the patient problem symptoms, such as heart
rate, blood pressure, muscle tension (EMG or elec-
tromyographic feedback), brain waves (EEC or elec-
troencophalographic feedback), respiration, and body
temperature (thermal feedback), and translates the infor-
mation into a visual and/or audible readout, such as a
paper tracing, a light display, or a series of beeps.

While the patient views the instantaneous feedback
from the biofeedback monitors, he or she begins to recog-
nize what thoughts, fears, and mental images influence his
or her physical reactions. By monitoring this relationship
between mind and body, the patient can then use these
same thoughts and mental images as subtle cues, as these
act as reminders to become deeply relaxed, instead of anx-
ious. These reminders also work to manipulate heart beat,
brain wave patterns, body temperature, and other bodily
functions. This is achieved through relaxation exercises,
mental imagery, and other cognitive therapy techniques.

As the biofeedback response takes place, patients
can actually see or hear the results of their efforts in-
stantly through the sensor readout on the biofeedback
equipment. Once these techniques are learned and the
patient is able to recognize the state of relaxation or vi-
sualization necessary to alleviate symptoms, the biofeed-
back equipment itself is no longer needed. The patient
then has a powerful, portable, and self-administered
treatment tool to deal with problem symptoms.

Biofeedback that specializes in reading and altering
brain waves is sometimes called neurofeedback. The
brain produces four distinct types of brain waves — delta,
theta, alpha, and beta — that all operate at a different fre-
quency. Delta, the slowest frequency wave, is the brain
wave pattern associated with sleep. Beta waves, which
occur in a normal, waking state, can range from 12-35
Hz. Problems begin to develop when beta wave averages
fall in the low end (underarousal) or the high end (over-
arousal) of that spectrum. Underarousal might be present
in conditions such as depression or attention-deficit dis-
order, and overarousal may be indicative of an anxiety
disorder, obsessive compulsive disorder, or excessive
stress. Beta wave neurofeedback focuses on normalizing
that beta wave pattern to an optimum value of around 14
Hz. A second type of neurofeedback, alpha-theta, focus-
es on developing the more relaxing alpha (8-13 Hz) and
theta waves (4-9 Hz) that are usually associated with
deep, meditative states, and has been used with some
success in substance abuse treatment.

Through brain wave manipulation, neurofeedback
can be useful in treating a variety of disorders that are
suspected or proven to impact brain wave patterns, such
as epilepsy, attention-deficit disorder, migraine
headaches, anxiety, depression, traumatic brain injury,

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

ELMER GREEN 1917-

A life dedicated to science has propelled Elmer
Green, Ph.D. into careers as a physicist and a biological
psychologist. Both led to his most noted work, the influ-
ence on the birth of the biofeedback movement. While
the mechanics of moving parts and machinery lured the
investigator from LaGrand, Oregon, to his work as a civil-
ian scientist with the Navy in the late 1940s, it was his
wife Alyce who caused him to ponder biophysiology and
human development. In 1953 she read a book titled The
Human Senses by Frank Geldard. It was their interests as a
couple that led to their continued education at the Uni-
versity of Chicago. In 1957 Green began work for his
Ph.D. studies in biopsychology, while Alyce studied for
her Master's degree in psychology.

Numerous opportunities, including assisting with
the development of a machine for the automated detec-
tion of brain damage, led to his position at the Men-
ninger Institute in Topeka, Kansas, in 1964. While there
he established the psychophysiology laboratory and the
Voluntary Controls Program. It was his treatment of a
colleague's wife's headaches that Green became con-
vinced that skin temperature was an autonomic nervous
system variable that was responsive to psychophysiolog-
ic self-regulation aided by thermal biofeedback. By
learning to control temperature he found that headache
control could be enhanced. Green's success attracted
support by several of the Menninger staff who also began
research and use of biofeedback therapy for headaches
and hypertension.

The 1960s proved exciting for Green as he, Alyce,
and colleague Dale Walters became involved with EEG
Biofeedback, and studied the process of meditation — a
therapy the Greens had long practiced. In April 1969,
Green and his wife organized the Council Grove Con-
ference for the study of the voluntary control of inter-
nal states. The conference served as a step toward
forming the Biofeedback Research Society, which later
became the Biofeedback Society of America, and cur-
rently the Association for Applied Psychophysiology
and Biofeedback.

Together, Elmer and Alyce Green authored numer-
ous papers, book chapters, and wrote the book, Beyond
Biofeedbaclc{'\977). They lectured throughout the United
States and around the world for more than 20 years on
multiple topics including EEG biofeedback training and
psychophysiologic control.

Green co-founded the International Society For the
Study of Subtle Energies and Energy Medicine (ISSSEEM)
in 1990 and served as its director. Alyce died in 1994 of
Alzheimer's disease. In 2000, 81 -year-old Green worked
as a professional consultant and director emeritus of the
Voluntary Controls Program at the Menninger Clinic. He
also served as the science director of the Dove Health Al-
liance in Aptos, California.

Beth A. Kapes

and sleep disorders. The equipment used for neurofeed-
back usually uses a monitor as an output device. The
monitor displays specific patterns that the patient at-
tempts to change by producing the appropriate type of
brain wave. Or, the monitor may reward the patient for
producing the appropriate brain wave by producing a
positive reinforcer, or reward. For example, children may
be rewarded with a series of successful moves in a dis-
played video game.

Depending on the type of biofeedback, individuals
may need up to 30 sessions with a trained professional to
learn the techniques required to control their symptoms
on a long-term basis. Therapists usually recommend that
their patients practice both biofeedback and relaxation
techniques on their own at home.

Preparations

Before initiating biofeedback treatment, the thera-
pist and patient will have an initial consultation to record

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

the patients medical history and treatment background
and discuss goals for therapy.

Before a neurofeedback session, an EEG is taken
from the patient to determine his or her baseline brain-
wave pattern.

Biofeedback typically is performed in a quiet and
relaxed atmosphere with comfortable seating for the pa-
tient. Depending on the type and goals of biofeedback
being performed, one or more sensors will be attached to
the patient’s body with conductive gel and/or adhesives.
These may include:

• Electromyographic (EMG) sensors. EMG sensors mea-
sure electrical activity in the muscles, specifically mus-
cle tension. In treating TMJ or bruxism, these sensors
would be placed along the muscles of the jaw. Chronic
pain might be treated by monitoring electrical energy in
other muscle groups.

• Galvanic skin response (GSR) sensors. These are elec-
trodes placed on the fingers that monitor perspiration,

221

Biofeedback

or sweat gland, activity. These may also be called skin
conductance level (SCL).

• Temperature sensors. Temperature, or thermal, sensors
measure body temperature and changes in blood flow.

• Electroencephalography (EEG) sensors. These elec-
trodes are applied to the scalp to measure the electrical
activity of the brain, or brain waves.

• Heart rate sensors. A pulse monitor placed on the finger
tip can monitor pulse rate.

• Respiratory sensors. Respiratory sensors monitor oxy-
gen intake and carbon dioxide output.

Precautions

Individuals who use a pacemaker or other im-
plantable electrical devices should inform their biofeed-
back therapist before starting treatments, as certain types
of biofeedback sensors have the potential to interfere
with these devices.

Biofeedback may not be suitable for some patients.
Patients must be willing to take a very active role in the
treatment process. And because biofeedback focuses
strictly on behavioral change, those patients who wish to
gain insight into their symptoms by examining their past
might be better served by psychodynamic therapy.

Biofeedback may also be inappropriate for cogni-
tively impaired individuals, such as those patients with
organic brain disease or a traumatic brain injury, depend-
ing on their levels of functioning.

Patients with specific pain symptoms of unknown
origin should undergo a thorough medical examination
before starting biofeedback treatments to rule out any se-
rious underlying disease. Once a diagnosis has been
made, biofeedback can be used concurrently with con-
ventional treatment.

Biofeedback may only be one component of a com-
prehensive treatment plan. For illnesses and symptoms
that are manifested from an organic disease process,
such as cancer or diabetes, biofeedback should be an ad-
junct to (complementary to), and not a replacement for,
conventional medical treatment.

Side effects

There are no known side effects to properly admin-
istered biofeedback or neurofeedback sessions.

Research & general acceptance

Preliminary research published in late 1999 indicated
that neurofeedback may be a promising new tool in the
treatment of schizophrenia. Researchers reported that

222

KEY TERMS

Autonomic nervous system — The part of the ner-
vous system that controls so-called involuntary
functions, such as heart rate, salivary gland secre-
tion, respiratory function, and pupil dilation.
Bruxism — Habitual, often unconscious, grinding
of the teeth.

Epilepsy — A neurological disorder characterized
by the sudden onset of seizures.

Placebo effect — Placebo effect occurs when a
treatment or medication with no known therapeu-
tic value (a placebo) is administered to a patient,
and the patient's symptoms improve. The patient
believes and expects that the treatment is going to
work, so it does. The placebo effect is also a factor
to some degree in clinically-effective therapies, and
explains why patients respond better than others to
treatment despite similar symptoms and illnesses.
Raynaud's syndrome — A vascular, or circulatory
system, disorder which is characterized by abnor-
mally cold hands and feet. This chilling effect is
caused by constriction of the blood vessels in the
extremities, and occurs when the hands and feet
are exposed to cold weather. Emotional stress can
also trigger the cold symptoms.

Schizophrenia — Schizophrenia is a psychotic dis-
order that causes distortions in perception (delu-
sions and hallucinations), inappropriate moods
and behaviors, and disorganized or incoherent
speech and behavior.

Temporomandibular joint disorder — Inflamma-
tion, irritation, and pain of the jaw caused by im-
proper opening and closing of the temporo-
mandibular joint. Other symptoms include click-
ing of the jaw and a limited range of motion.

schizophrenic patients had used neurofeedback to simulate
brain wave patterns that antipsychotic medications produce
in the brain. Further research is needed to determine what
impact this may have on treatment for schizophrenia.

The use of biofeedback techniques to treat an array
of disorders has been extensively described in the med-
ical literature. Controlled studies for some applications
are limited, such as for the treatment of menopausal
symptoms and premenstrual disorder (PMS). There is
also some debate over the effectiveness of biofeedback
in ADHD treatment, and the lack of controlled studies on
that application. While many therapists, counselors, and

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

mental health professionals have reported great success
with treating their ADHD patients with neurofeedback
techniques, some critics attribute this positive therapeu-
tic impact to a placebo effect.

There may also be some debate among mental
health professionals as to whether biofeedback should be
considered a first line treatment for some mental illness-
es, and to what degree other treatments, such as medica-
tion, should be employed as an adjunct therapy.

Training & certification

Individuals wishing to try biofeedback should con-
tact a healthcare professional trained in biofeedback
techniques. Licensed psychologists, psychiatrists, and
physicians frequently train their patients in biofeedback
techniques, or can recommend a specialist who does. In
some cases, a licensed professional may employ a
biofeedback technician who works under their direct
guidance when treating patients. There are several na-
tional organizations for biofeedback therapists, including
the Biofeedback Certification Institute of America,
which also certifies therapists in the practice.

Resources

BOOKS

Robbins, Jim. A Symphony in the Brain: The Evolution of the
New Brain Wave Biofeedback. Boston, MA: Atlantic
Monthly Press, 2000.

PERIODICALS

Burgio, K.L. et al. “Behavioral vs. Drug Treatment for Urge
Urinary Incontinence in Older Women: A randomized
controlled trial.” Journal of the American Medical Associ-
ation 280 (Dec. 1998): 1995-2000.

Robbins, Jim. “On the Track with Neurofeedback.” Newsweek
135, no. 25 (June 2000): 76.

ORGANIZATIONS

The Association for Applied Psychotherapy and Biofeedback.
10200 W. 44th Avenue, Suite 304. Wheat Ridge, CO
80033-2840. (303) 422-8436. <http://www.aapb.org>.
Biofeedback Certification Institute of America. 10200 W. 44th Av-
enue, Suite 310, Wheat Ridge, CO 80033. (303) 420-2902.

Paula Ford-Martin

Bioflavonoids

Description

Bioflavonoids, or flavonoids, are a large class of an-
tioxidants. They are compounds abundant in the pulp

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

and rinds of citrus fruits and other foods containing vita-
min C, such as soybeans and root vegetables. Other
major sources of bioflavonoids include tea, vegetables
such as broccoli and eggplant, flaxseed, and whole
grains. Bioflavonoids are active ingredients in many
herbal remedies. These include feverfew, Tanacetum
parthenium; Ginkgo biloba; licorice root, Glycyrrhiza
glabra; St. John’s wort, Hypericum perforatum; and
Echinacea spp.

Bioflavonoids help maximize the benefits of vitamin
C by inhibiting its breakdown in the body. In 1935, Albert
Szent-Gyorgyi demonstrated that an extract he called cit-
rin, made from lemon peels, was more effective than pure
vitamin C in preventing scurvy. In 1936, Szent-Gyorgyi
found that citrin was a mixture of bioflavonoids, includ-
ing the flavone hesperidin and a flavonol glucoside.
Szent-Gyorgyi believed that bioflavonoids should be con-
sidered vitamins, but was not able to substantiate that
they were essential nutrients. Still, many researchers and
physicians believe that dietary intake of bioflavonoids is
beneficial for blood vessel health and possibly for protec-
tion against heart disease.

Bioflavonoids are categorized in a variety of ways,
sometimes with overlapping categories. Types of
bioflavonoids include flavones, isoflavonoids, flavanones
(such as catechins and naringin), and flavanols.

General use

In their natural state, bioflavonoids are usually
found in close association with vitamin C. In treating
conditions, vitamin C and bioflavonoids each enhance
the action of the other compound. Therefore, when taken
as supplements, they often should be used in combina-
tion to increase effectiveness. In general, all
bioflavonoids are potentially useful as antioxidants, an-
tivirals, and anti-inflammatories. Other health benefits of
the various bioflavonoids include:

• preventing nosebleeds, miscarriages, postpartum
bleeding, and other types of hemorrhages

• the treatment and prevention of menstrual disorders

• protection against cancer and heart disease

• anticoagulant activity (preventing blood clotting)

• reducing the occurrence of easy bruising

• decreasing the cholesterol level

• improving symptoms related to aging

• protection against infections

• counteracting the effects of pollution, pesticides, rancid
fats, and alcohol

• ability to reduce pain

223

Bioflavonoids

• improving the circulation

• improving liver function

• improvement of vision and eye diseases

• strengthening the walls of the blood vessels

Major bioflavonoids and their actions

Rutin can be used to treat chronic venous insuffi-
ciency (condition in which blood drains inadequately
from a body part), glaucoma, hay fever, hemorrhoids,
varicose veins, poor circulation, oral herpes, cirrhosis,
stress, low serum calcium, and for cataracts. It is help-
ful in reducing weakness in the blood vessels and the re-
sultant hemorrhages. Rutin can relieve the pain from
bumps and bruises. Rutin may be taken to help reduce
serum cholesterol. It is also useful in treating rheumatic
diseases such as gout, arthritis, systemic lupus erythe-
matosus (a chronic disease marked by a rash on the face
with a variety of symptoms), and ankylosing spondyli-
tis (condition affecting ligaments in the spine, involving
the hips and shoulders). Rutin is most abundant in apri-
cots, buckwheat, cherries, prunes, rose hips, the whitish
rind of citrus fruits, and the core of green peppers.

Anthocyanins and proanthocyanidins can be used to
treat a number of eye conditions such as cataracts, night
blindness, diabetic retinopathy (progressive retina dis-
ease that is a complication of diabetes), and macular de-
generation (a hereditary condition causing loss of vi-
sion). They are also useful for strengthening the walls of
the blood vessels, and therefore may help prevent bruis-
ing, hemorrhoids, varicose veins, and spider veins. These
bioflavonoids can help to prevent osteoporosis by stabi-
lizing collagen, the major protein in bone. They can re-
duce cholesterol deposits in arteries, and prevent damage
to the artery walls. These actions reduce the possibilities
of heart disease and strokes. Anthocyanins and proantho-
cyanidins can dilate the blood vessels and prevent blood
clots. Proanthocyanidins are able to cross the blood-
brain barrier to protect the brain from damage by free
radicals and infection. Good sources of anthocyanins and
proanthocyanidins include blackberries, cranberries,
black and green tea, raspberries, grapes, eggplant, red
cabbage, elderberries, and red wine.

Hesperidin is useful in treating the complaints of
menopause and in dealing with the viruses that cause
herpes, the flu, and certain respiratory ailments. Hes-
peridin fights allergic reactions by blocking the release
of histamine. It may also help reduce edema (accumula-
tion of fluid) in the legs. Hesperidin deficiency has been
linked to weaknesses in the walls of the blood vessels,
pain and weakness in the hands and feet, and leg cramps
at night. Hesperidin is mostly found in the pulps and
rinds of citrus fruits.

224

Ellagic acid helps to inhibit cancer by neutralizing
the effect of certain carcinogens. It is particularly helpful
in reducing the effects of nitrosamines, which are found
in tobacco and processed meat products such as bacon
and hot dogs. Ellagic acid reduces the effects of the toxic
and carcinogenic factors (aflatoxins) produced by As-
pergillus flavus molds on food. Aflatoxins may cause
liver damage and cancer. Ellagic acid diminishes the ef-
fects of polycyclic hydrocarbons produced by tobacco
smoke and air pollution, as well. Sources of ellagic acid
include strawberries, grapes, apples, cranberries, black-
berries, and walnuts.

Quercetin is a good antihistamine. It can help reduce
the inflammation that results from hay fever, allergies,
bursitis, gout, arthritis, and asthma. It may lessen other
asthma symptoms. Quercetin stimulates detoxification
in the liver. It strengthens the blood vessels, and is useful
in treating atherosclerosis (plaque build-up in the arter-
ies) and high cholesterol levels. It may help inhibit tumor
formation. Quercetin can be used to treat many of the
complications of diabetes. For example, it blocks the ac-
cumulation of sorbitol, which has been linked with
nerve, eye and kidney damage in diabetics; and it regu-
lates blood sugar levels. Quercetin inhibits the growth of
Helicobacter pylori, which has been implicated in the
development of peptic ulcers. It can also help diminish
the effects of the herpes virus, the Epstein-Barr virus (a
common virus; a common cause of mononucleosis), and
the polio virus. Quercetin is found in green tea, onion-
skins, kale, red cabbage, green beans, tomatoes, pota-
toes, lettuce, strawberries, cherries, and grapes. It is also
found in smaller amounts in many other foods.

Catechins and tannins can be used to stimulate
detoxification by the liver and to strengthen the blood
vessels. They also help reduce the inflammatory re-
sponse. Catechins and tannins may help inhibit the for-
mation of tumors. In addition, catechins can be used to
inhibit the breakdown of collagen and to treat hepatitis
and arthritis. Catechins and tannins are both found in
green and black teas.

Kaempferols stimulate liver detoxification and
strengthen the blood vessels. They may also inhibit
tumor formation. Strawberries, leeks, kale, broccoli,
radishes, endives, and red beets all are good sources of
kaempferols, but kaempferols are very common and
found in many plants and foods. Naringen may slow the
progression of heart disease and visual degeneration in
diabetes. It is a potent anticoagulant that keeps the arter-
ies clear and strong to prevent strokes, heart attacks, and
the blindness of diabetes. Naringen is an active ingredi-
ent of in grapefruits. Genestein is known to be a regula-
tor of estrogen. It is good for treating disorders of men-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

KEY TERMS

Antioxidants — Nutrients that protect against oxi-
dation, a chemical reaction that can damage
human cells.

Blood-brain barrier — A feature of the brain
thought to consist of walls of capillaries that pre-
vent or delay the passage of some drugs and
chemicals into the central nervous system.

Free radicals — By-products of the process of form-
ing energy in the human body. Free radicals are
atoms or groups of atoms with an odd number of
electrons. They can damage important cellular
components, and can be checked by antioxidants.

struation and menopause. Genestein is found in soy-
beans and soy products.

Preparations

Since bioflavonoids are so widely available in fruits
in high concentrations, daily servings of whole fresh fruits
and fresh fruit juices should be consumed. Highly concen-
trated liquid extracts of some fruits are also available.

Precautions

Bioflavonoids are generally safe, even at very high
doses. However, pregnant women are advised not to take
megadoses of bioflavonoids. Preliminary studies have in-
dicated that there may be a link between infant leukemia
and high doses of bioflavonoids in the mother.

Side effects

Bioflavonoids are not toxic, even at high levels.
They are water soluble, and therefore, any in excess of
what is needed by the body is excreted in the urine.

Interactions

Bioflavonoids are usually found in close association
with vitamin C, and they enhance its effect. There are no
known drug interactions.

Resources

BOOKS

The Editors of Time-Life Books. The Drug &Natural Medicine
Advisor. Alexandria, Virginia: Time-Life Custom Publish-
ing, 1997.

Griffith, H., M.D. Vitamins, Minerals, & Supplements: The
Complete Guide. Arizona: Fisher Books, 1998.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Ronzio, Robert A. The Encyclopedia of Nutrition and Good
Health. New York: Facts on File, 1997.

Winter. Ruth, M.S. A Consumer’s Guide to Medicines in Food
New York: Random House, 1995.

OTHER

"All About Bioflavonoids.” MotherNature.com. http://www.
mothernature.com/articles/bioflavonoids/articlel.stm
(January 17, 2001).

Passwater. Richard A., Ph.D. “Bioflavonoids, ‘Vitamin P' and
Inflammation: An Interview with Dr. Miklos Gabor.” http://
www.nutritionfocus.com/nutrition_library/gabor_interview.
html (January 17, 2001).

Wolinsky, Howard. “Large Doses of Bioflavonoids Linked to
Leukemia in Children Pregnant Women Should Avoid
Megadoses, Researchers Say.” WehMD Medical News .
April 18, 2000. http://my.webmd.com/content/article/
1728.56735 (January 17, 2001).

Patience Paradox

Biological dentistry see Holistic dentistry

Biota

Description

Biota is the common name for Biota orientalis. It is
used in Chinese healing and called bai zi ren. In English
biota is sometimes called oriental arborvitae.

Biota is a slow-growing tree native to China. It
grows to a height of about 45 ft (15 m) in moist, well-
drained soils throughout East Asia. It tolerates air pollu-
tion well and will grow in cities. When cultivated, biota
produces an abundant seed crop. The leaves and seeds
are used in healing. A yellow dye can be made from the
young branches. Many varieties of biota are used for or-
namental landscaping.

Biota is an herb that is sometimes confused with
Thuja occidentalis. Thuja is a North American tree in the
cedar family that is called American arborvitae. The
leaves of thuja are sometimes used by Western herbalists,
but are used in very different ways from I). orientalis.

General use

Biota is one of the less important of the 50 funda-
mental herbs of Chinese herbalism. In Chinese herbal-
ism, biota is said to have a neutral nature and a sweet,
acid taste. It is associated primarily with the heart and di-
gestive system and is often a component of shen tonics.

Biota seeds are used as a sedative, to help disperse
anxiety and fear, and to reduce insomnia. Other uses are

225

Biota

Biotin

to treat heart palpitations, nervous disorders, night
sweats, and constipation. Biota is said to be especially
helpful for treating constipation in the elderly due to its
oily nature.

Biota leaves, either fresh or dried, are used to treat a
variety of conditions including:

• stopping various kinds of bleeding

• bacterial infection

• fever

• cough

• bronchitis

• asthma

• premature baldness

• skin infections

• mumps

• arthritis pain

• dysentery caused by bacteria

• constipation

Biota is an herb that has not received much attention
from scientists. There are very few chemical analyses or
laboratory studies done on biota leaves or seeds in either
Asia or the United States. Virtually all health claims for
this herb are based on its use in traditional Chinese
medicine and observations of herbalists rather than con-
trolled scientific studies.

Preparations

Biota seeds are prepared by boiling, and extracts are
made of the leaves. Commercially most biota is sold as
capsules. Most often biota is used as part of a formula or
tonic. It is a component of formulas that tend to stimulate
the heart and relieve stress, fatigue, and forgetfulness.

Biota is one ingredient of the cerebral tonic pills
called bu nao wan. These pills are used to improve con-
centration and treat conditions such as Alzheimer disease.
They are also given to combat restlessness and agitation.

Another common formula that contains biota is gin-
seng and zizyphus (tian wang bu xin dan). This formula
treats insomnia and disturbed sleep, nightmares, anxiety,
restlessness, forgetfulness, heart palpitations, and hard,
dry bowel movements. It is available in both tea and cap-
sule form. Dosage varies considerably depending on the
formula and the condition being treated.

Precautions

Some herbal practitioners recommend that biota not
be taken by pregnant women.

226

KEY TERMS

Shen — Shen is one of the five body energies. It in-
fluences mental, spiritual, and creative energy. Shen
tonics address deficiencies in this type of energy.

Side effects

No undesirable side effects have been reported.

Interactions

Biota and other Chinese herbs are often used togeth-
er with no reported interactions. Since biota has been
used almost exclusively in Chinese medicine, there are no
studies of its interactions with Western pharmaceuticals.

Resources

BOOKS

Molony, David. Complete Guide to Chinese Herbal Medicine.

New York: Berkeley Books, 1998.

Teegaurden. Ron. The Ancient Wisdom of the Chinese Tonic
Herbs. New York: Warner Books, 1998.

ORGANIZATIONS

American Association of Oriental Medicine. 433 Front Street,
Catasauqua, PA 18032. (610) 266-2433.

Tish Davidson

Biotin

Description

Biotin is a member of the B complex family, but is
not actually a vitamin. It is a coenzyme that works with
them. Also known as vitamin H and coenzyme R, it was
first isolated and described in 1936. It is water soluble
and very unstable; it can be destroyed by heat, cooking,
exposure to light, soaking, and prolonged contact with
water, baking soda, or any other alkaline element. The
body obtains biotin from food and can also synthesize
this nutrient from bacteria in the gut.

General use

Biotin is utilized by every cell in the body and con-
tributes to the health of skin, hair, nerves, bone marrow,
sex glands, and sebaceous glands. Apart from being a
vital cofactor to several enzymes, biotin is essential in

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

carbohydrate metabolism and the synthesis of fatty
acids. It is also involved in the transformation of amino
acids into protein. Biotin plays a role in cell growth and
division through its role in the manufacture of DNA and
RNA, the genetic components of cells.

Adequate biotin is required for healthy nails and
hair, and biotin deficiency is known to be a factor in
balding and the premature graying of hair. It has been
claimed that, as part of an orthomolecular regime, it can
reverse the graying of hair. When PABA and biotin are
taken together in adequate amounts they can restore hair
color. Biotin supplements will also effectively treat
weak, splitting nails.

Biotin can be a valuable tool to combat yeast infec-
tions, which are notoriously difficult to fight. In their
book The Yeast Syndrome , John Parks Trowbridge and
Morton Walker describe how adequate levels of biotin
can prevent Candida albicans from developing from its
yeast-like state into fungal form, in which it sends out
mycelium that further invade body organs.

Seborrheic dermatitis, or Leiner’s disease, which is
a non-itchy, red scaling rash affecting infants during the
first three months of life, is also treated with biotin and
other B complex vitamins.

Biotin has been used in conjunction with other nu-
trients as part of weight loss programs, as it aids in the
digestion and breakdown of fats.

High doses of biotin are sometimes used by the allo-
pathic medical profession to treat diabetes since it en-
hances sensitivity to insulin and effectively increases
levels of enzymes involved in glucose metabolism. In
2002, one company started clinical trials testing a combi-
nation of chromium picolinate and biotin for treatment
of type 2 diabetes. Biotin is also used to treat peripheral
neuropathy, a complication of diabetes, and patients
with Duchenne muscular dystrophy, who suffer from
metabolic deficiencies.

Biotin can be found in beans, breads, brewer’s
yeast, cauliflower, chocolate, egg yolks, fish, kidney,
legumes, liver, meat, molasses, dairy products, nuts, oat-
meal, oysters, peanut butter, poultry, wheat germ, and
whole grains.

Preparations

The recommended daily allowance for adults in the
United States is 30 meg. Daily requirements are estimat-
ed at 30 meg for adults and 35 meg for women who are
nursing. Supplementation ranges from 100-600 meg per
day, and can be obtained in the form of brewer’s yeast,
which contains biotin as part of the B complex, or as an
individual biotin supplement.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Precautions

The body needs biotin on a daily basis since it is not
stored to any great extent. Biotin requirements increase
during pregnancy and lactation. In 2002, an investigation
outlined the need for supplemental biotin during pregnan-
cy. Nearly 50 % of pregnant women appear to be defi-
cient in biotin, which could result in birth defects (at least
according to animal studies). Researchers suggest that bi-
otin be included in prenatal multivitamin formulas.

Those taking antibiotics should supplement their
diets with biotin. Certain individuals are at risk for bi-
otin deficiency, including infants fed biotin-deficient for-
mula or with inherited deficiency disorders, patients who
are fed intravenously, and anyone who habitually eats a
lot of raw egg whites, because they contain a protein
called avidin, which prevents the absorption of biotin.

Mild deficiency

Because it is synthesized in the gut, deficiency
symptoms of biotin are rare. However they may include
weakness, lethargy, grayish skin color, eczema (which
may include a scaly red rash around the nose, mouth and
other orifices), hair loss, cradle cap in infants, muscle
aches, impaired ability to digest fats, nausea, depres-
sion, loss of appetite, insomnia, high cholesterol levels,
eye inflammations, sensitivity to touch, anemia, and tin-
gling in the hands and feet.

Extreme deficiency

Symptoms of extreme biotin deficiency include ele-
vation of cholesterol levels, heart problems, and paraly-
sis. When extreme deficiency is a problem, the liver may
not be able to detoxify the body efficiently, and depres-
sion may develop into hallucinations. Infants may exhib-
it developmental delay and lack of muscle tone.

Biotin deficiency could result in a loss of immune
function, since animal experiments have shown that bi-
otin deficiency resulted in a decrease in white blood-cell
function. Because biotin is essential to the body’s meta-
bolic functions, any deficiency could result in impaired
metabolism as well.

Overdose

There have been no reports of effects of overdose of
biotin, even at very high doses, primarily because any
excess is excreted in the urine.

Side effects

There are no side effects associated with biotin sup-
plementation.

227

Biotin

Bipolar disorder

KEY TERMS

Coenzyme — A non-protein organic compound
that plays an essential role in the action of particu-
lar enzymes.

Lactobacillus — A bacteria present in the gut of
healthy people.

Mycelium — Fine thread-like tendrils sent out by a
fungus to seek nutrition, capable of invading body
organs.

Peripheral neuropathy — Weakness and numbness
of the nerves in the fingers and toes, which may
progress up the limb — often a complication of di-
abetes.

Interactions

Biotin works in conjunction with all the B vitamins,
which are synergistic, meaning they work best when all
are available in adequate amounts.

Raw egg white contains the protein avidin, which
prevents absorption of biotin.

Sulfa drugs, estrogen, and alcohol all increase the
amount of biotin needed in the body. In addition, anti-
convulsant drugs may lead to biotin deficiency. Long
term use of antibiotics may prevent the synthesis of bi-
otin in the gut by killing off the bacteria which help the
body produce biotin. Supplements of lactobacillus may
help the body make sufficient amounts of biotin after
long term antibiotic use.

Resources

BOOKS

Kenton, Leslie. The Joy of Beauty. Great Britain: Century Pub-
lishing Co Ltd., 1983.

Trowbridge, John Parks, and Morton Walker. The Yeast Syn-
drome. New York: Bantam Books, 1986.

PERIODICALS

“Biotin Deficiency in Pregnancy. (Nutrition and Pregnancy).”
Nutrition Research Newsletter (April 2002): 9—11.

Gaby, Alan R. “Biotin Needed During Pregnancy.” Townsend
Letter for Doctors and Patients (June 2002): 31.
“Nutrition 21 to Test Chromium/Biotin Combo in Diabetes.”
Nutraceuticals International (May 2002).

OTHER

“Vitamins, etc.” [cited August 1, 2000] <http://www.book-
man.com.au/vitamins/biotin. html> .

Patricia Skinner
Teresa G. Odle

228

Bipolar disorder

Definition

Bipolar, or manic-depressive disorder, is a mood
disorder that causes radical emotional changes and mood
swings, from manic highs to depressive lows. The major-
ity of bipolar individuals experience alternating episodes
of mania and depression.

Description

In the United States alone, bipolar disorder afflicts
approximately 2.3 million people, and nearly 20% of this
population will attempt suicide without effective treat-
ment intervention. The average age at onset of bipolar
disorder is from adolescence through the early twenties.
However, because of the complexity of the disorder, a
correct diagnosis can be delayed for several years or
more. In a survey of bipolar patients conducted by the
National Depressive and Manic Depressive Association
(NDMDA), one-half of respondents reported visiting
three or more professionals before receiving a correct di-
agnosis, and over one-third reported a wait of 10 years or
more before they were correctly diagnosed.

The Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition ( DSM-IV ), the diagnostic stan-
dard for mental health professionals in the United States,
defines four separate categories of bipolar disorder:
bipolar I, bipolar II, cyclothymia, and bipolar not-other-
wise-specified (NOS).

Bipolar I disorder is characterized by manic
episodes, the “high” of the manic-depressive cycle. A
bipolar patient experiencing mania often has feelings of
self-importance, elation, talkativeness, increased sociabil-
ity, and a desire to embark on goal-oriented activities,
coupled with the characteristics of irritability, impatience,
impulsiveness, hyperactivity, and a decreased need for
sleep. Usually this manic period is followed by a period
of depression, although a few bipolar I individuals may
not experience a major depressive episode. Mixed states,
where both manic or hypomanic symptoms and depres-
sive symptoms occur at the same time, also occur fre-
quently with bipolar I patients (for example, depression
with racing thoughts of mania). Also, dysphoric mania is
common (mania characterized by anger and irritability).

Bipolar II disorder is characterized by major depres-
sive episodes alternating with episodes of hypomania, a
milder form of mania. Bipolar depression may be difficult
to distinguish from a unipolar major depressive episode.
Patients with bipolar depression tend to have extremely
low energy, retarded mental and physical processes, and
more profound fatigue (for example, hypersomnia; a

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

sleep disorder marked by a need for excessive sleep or
sleepiness when awake) than unipolar depressives.

Cyclothymia refers to the cycling of hypomanic
episodes with depression that does not reach major de-
pressive proportions. One-third of patients with cy-
clothymia will develop bipolar I or 11 disorder later in life.

A phenomenon known as rapid cycling occurs in up
to 20% of bipolar I and II patients. In rapid cycling,
manic and depressive episodes must alternate frequently,
at least four times in 12 months, to meet the diagnostic
definition. In some cases of “ultra-rapid cycling,” the pa-
tient may bounce between manic and depressive states
several times within a 24-hour period. This condition is
very hard to distinguish from mixed states.

Bipolar NOS is a category for bipolar states that do not
clearly fit into the bipolar I, II, or cyclothymia diagnoses.

Causes & symptoms

The source of bipolar disorder has not been clearly
defined. Because two-thirds of bipolar patients have a
family history of affective or emotional disorders, re-
searchers have searched for a genetic link to the disorder.
Several studies have uncovered a number of possible ge-
netic connections to the predisposition for bipolar disor-
der. Recent studies emphasize a hereditary connection
and early research links several chromosomes, one par-
ticularly related to bipolar II, to development of the dis-
order. A 2003 study found that schizophrenia and bipo-
lar disorder could have similar genetic causes that arise
from certain problems with genes associated with myelin
development in the central nervous system. (Myelin is a
white, fat-like substance that forms a sort of layer or
sheath around nerve fibers.)

Another possible biological cause under investiga-
tion is the presence of an excessive calcium build-up in
the cells of bipolar patients. Also, dopamine and other
neurochemical transmitters appear to be implicated in
bipolar disorder and these are under intense investigation.

Over one-half of patients diagnosed with bipolar
disorder have a history of substance abuse. There is a
high rate of association between cocaine abuse and bipo-
lar disorder. Some studies have shown up to 30% of
abusers meeting the criteria for bipolar disorder. The
emotional and physical highs and lows of cocaine use
correspond to the manic depression of the bipolar pa-
tient, making the disorder difficult to diagnose.

For some bipolar patients, manic and depressive
episodes coincide with seasonal changes. Depressive
episodes are typical during winter and fall, and manic
episodes are more probable in the spring and summer
months.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Symptoms of bipolar depressive episodes include
low energy levels, feelings of despair, difficulty concen-
trating, extreme fatigue, and psychomotor retardation
(slowed mental and physical capabilities). Manic
episodes are characterized by feelings of euphoria, lack
of inhibitions, racing thoughts, diminished need for
sleep, talkativeness, risk taking, and irritability. In ex-
treme cases, mania can induce hallucinations and other
psychotic symptoms such as grandiose illusions.

Diagnosis

Bipolar disorder usually is diagnosed and treated by
a psychiatrist and/or a psychologist with medical assis-
tance. In addition to an interview, several clinical inven-
tories or scales may be used to assess the patient’s men-
tal status and determine the presence of bipolar symp-
toms. These include the Millon Clinical Multiaxial In-
ventory III (MCMI-III), Minnesota Multiphasic
Personality Inventory II (MMPI-2), the Internal State
Scale (ISS), the Self-Report Manic Inventory (SRMI),
and the Young Mania Rating Scale (YMRS). The tests
are verbal and/or written and are administered in both
hospital and outpatient settings.

Psychologists and psychiatrists typically use the cri-
teria listed in the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV) as a guide-
line for diagnosis of bipolar disorder and other mental
illnesses. DSM-IV describes a manic episode as an ab-
normally elevated or irritable mood lasting a period of at
least one week that is distinguished by at least three of
the mania symptoms: inflated self-esteem, decreased
need for sleep, talkativeness, racing thoughts, dis-
tractibility, increase in goal-directed activity, or exces-
sive involvement in pleasurable activities that have a
high potential for painful consequences. If the mood of
the patient is irritable and not elevated, four of the symp-
toms are required.

Although many clinicians find the criteria too rigid,
a hypomanic diagnosis requires a duration of at least
four days with at least three of the symptoms indicated
for manic episodes (four if mood is irritable and not ele-
vated). DSM-IV notes that unlike manic episodes, hypo-
manic episodes do not cause a marked impairment in so-
cial or occupational functioning, do not require hospital-
ization, and do not have psychotic features. In addition,
because hypomanic episodes are characterized by high
energy and goal directed activities and often result in a
positive outcome, or are perceived in a positive manner
by the patient, bipolar II disorder can go undiagnosed.

In late 2001, a study reported at an international
psychiatric conference that impulsivity remains a key

229

Bipolar disorder

distinguishing characteristic for bipolar disorder, at least
when patients are in manic phases.

Bipolar symptoms often present differently in chil-
dren and adolescents. Manic episodes in these age groups
typically are characterized by more psychotic features
than in adults, which may lead to a misdiagnosis of schiz-
ophrenia. Children and adolescents also tend toward irri-
tability and aggressiveness instead of elation. Further,
symptoms tend to be chronic, or ongoing, rather than
acute, or episodic. Bipolar children are easily distracted,
impulsive, and hyperactive, which can lead to a misdiag-
nosis of attention-deficit hyperactivity disorder
(ADHD). Furthermore, their aggression often leads to vio-
lence, which may be misdiagnosed as a conduct disorder.

Substance abuse, thyroid disease, and use of pre-
scription or over-the-counter medication can mask or
mimic the presence of bipolar disorder. In cases of sub-
stance abuse, the patient must ordinarily undergo a peri-
od of detoxification and abstinence before a mood dis-
order is diagnosed and treatment begins.

Treatment

Alternative treatments for bipolar disorder generally
are considered to be complementary treatments to con-
ventional therapies. General recommendations for con-
trolling bipolar symptoms include maintaining a calm
environment, avoiding overstimulation, getting plenty of
rest, regular exercise, and proper diet. Psychotherapy
and counseling are generally recommended treatments
for the disease, whether treated alternatively or allopathi-
cally. Psychotherapy, such as cognitive-behavioral thera-
py, can be a useful tool in helping patients and their fam-
ilies adjust to the disorder and in reducing the risk of sui-
cide. Also, educational counseling is recommended for
the patient and family. In fact, a 2003 report revealed that
people on medication for bipolar disorder have better re-
sults if they also participate in family-focused therapy.

Chinese herbs also may help to soften mood swings.
Traditional Chinese medicine (TCM) remedies are pre-
scribed based on the patient’s overall constitution and the
presentation of symptoms. These remedies can stabilize
moods, not just treat swings in mood. A TCM practitioner
might recommend a mixture called the Iron Filings Com-
bination (which includes the Chinese herbs asparagus,
ophiopogon, fritillaria, arisaema, orange peel, polygala,
acorns, forsythia, hoelen, fu-shen, scrophularia, uncaria
stem, salvia, and iron filings) to treat certain types of
mania in the bipolar patient. There are other formulas for
depression. A trained practitioner should guide all of these
remedies. Compliance can be better with natural remedies
if they work. These remedies do not flatten moods and
people in manic states do not like to be suppressed.

230

Acupuncture can be used for treatment to help
maintain a more even temperament.

Biofeedback is effective in helping some patients
control symptoms such as irritability, poor self control,
racing thoughts, and sleep problems. A diet low in vana-
dium (a mineral found in meats and other foods) and
high in vitamin C may be helpful in reducing depression.

In 2003, a report stated that rhythm therapy, or sim-
ply taking steps to go to bed and wake up at consistent
times each day, helps some people with bipolar disorder
maintain mood stability, especially when faced with psy-
chosocial stress.

Recommended herbal remedies to ease depressive
episodes may include damiana ( Turnera diffusa), gin-
seng ( Panax ginseng), kola (Cola nitida), lady’s slipper
(Cypripedium calceolus), lavender (Lavandula angusti-
folia), lime blossom (Tilia x vulgaris), oats (Avena
sativa), rosemary ( Rosmarinus officinalis), skullcap
(Scutellaria laterifolia), St. John’s wort (Hypericum
perforatum), valerian (Valeriana officinalis), and ver-
vain ( Verbena officinalis).

Allopathic treatment

Allopathic treatment of bipolar disorder is usually
by means of medication. A combination of mood stabi-
lizing agents with antidepressants, antipsychotics, and
anticonvulsants is used to regulate manic and depressive
episodes.

Mood stabilizing agents such as lithium, carba-
mazepine, and valproate are prescribed to regulate the
manic highs and lows of bipolar disorder:

• Lithium (Cibalith-S, Eskalith, Lithane, Lithobid,
Lithonate, Lithotabs) is one of the oldest and most fre-
quently prescribed drugs available for the treatment of
bipolar mania and depression. Lithium has also been
shown to be effective in regulating bipolar depression, but
is not recommended for mixed mania. Possible side ef-
fects of the drug include weight gain, thirst, nausea and
hand tremors. Prolonged lithium use may also cause hy-
perthyroidism (a disease of the thryoid that is marked by
heart palpitations, nervousness, the presence of goiter,
sweating, and a wide array of other symptoms).

• Carbamazepine (Tegretol, Atretol) is an anticonvulsant
drug usually prescribed in conjunction with other mood
stabilizing agents. The drug is often used to treat bipo-
lar patients who have not responded well to lithium
therapy. Blurred vision and abnormal eye movement
are two possible side effects of carbamazepine therapy.

• Valproate (divalproex sodium, or Depakote; valproic
acid, or Depakene) is one of the few drugs available that
has been proven effective in treating rapid cycling bipo-

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

lar and mixed states patients. Valproate is prescribed
alone or in combination with carbamazepine and/or
lithium. Stomach cramps, indigestion, diarrhea, hair
loss, appetite loss, nausea, and unusual weight loss or
gain are some of the common side effects of valproate.

Because antidepressants may stimulate manic
episodes in some bipolar patients, their use is typically
short-term. Selective serotonin reuptake inhibitors
(SSRIs) or, less often, monoamine oxidase inhibitors
(MAOIs) are prescribed for episodes of bipolar depres-
sion. Tricyclic antidepressants used to treat unipolar de-
pression may trigger rapid cycling in bipolar patients and
are, therefore, not a preferred treatment option for bipo-
lar depression.

Electroconvulsive therapy (ECT), has a high success
rate for treating both unipolar and bipolar depression,
and mania. However, because of the convenience of drug
treatment and the stigma sometimes attached to ECT
therapy, ECT usually is employed after all pharmaceuti-
cal treatment options have been explored. ECT is given
under anesthesia and patients are given a muscle relaxant
medication to prevent convulsions. The treatment con-
sists of a series of electrical pulses that move into the
brain through electrodes on the patient’s head. Although
the exact mechanisms behind the success of ECT thera-
py are not known, it is believed that this electrical cur-
rent alters the electrochemical processes of the brain,
consequently relieving depression. In bipolar patients,
ECT often is used in conjunction with drug therapy.

Long-acting benzodiazepines such as clonazepam
(Klonapin) and alprazolam (Xanax) are used for rapid
treatment of manic symptoms to calm and sedate pa-
tients until mania or hypomania have waned and mood
stabilizing agents can take effect. Neuroleptics such as
chlorpromazine (Thorazine) and haloperidol (Haldol)
also are used to control mania while a mood stabilizer
such as lithium or valproate takes effect. Clozapine
(Clozaril) is an atypical antipsychotic medication used to
control manic episodes in patients who have not re-
sponded to typical mood stabilizing agents. The drug
also has been a useful prophylactic, or preventative treat-
ment, in some bipolar patients.

The treatment rTMS, or repeated transcranial mag-
netic stimulation, is a relatively new and still experimen-
tal treatment for the depressive phase of bipolar disorder.
In rTMS, a large magnet is placed on the patient’s head
and magnetic fields of different frequency are generated
to stimulate the left front cortex of the brain. Unlike
ECT, rTMS requires no anesthesia and does not induce
seizures.

GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2

Expected results

While most patients will show some positive re-
sponse to treatment, response varies widely, from full re-
covery to a complete lack of response to all treatments,
alternative or allopathic. Drug therapies frequently need
adjustment to achieve the maximum benefit for the pa-
tient. Bipolar disorder is a chronic recurrent illness in
over 90% of those afflicted, and one that requires life-
long observation and treatment after diagnosis. Patients
with untreated or inadequately treated bipolar disorder
have a suicide rate of 15-25% and a nine-year decrease
in life expectancy. With proper treatment, the life ex-
pectancy of the bipolar patient will increase by nearly
seven years and work productivity increases by 10 years.

Prevention

The ongoing medical management of bipolar disor-
der is critical to preventing relapse, or recurrence, of
manic episodes. Even in carefully controlled treatment
programs, bipolar patients may experience recurring
episodes of the disorder. Patient education in the form of
psychotherapy or self-help groups is crucial for training
bipolar patients to recognize signs of mania and depres-
sion and to take an active part in their treatment program.

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders. 4th ed. Washington, DC:
American Psychiatric Press, Inc., 1994.

Whybrow, Peter C. A Mood Apart. New York: Harper Collins,
1997.

PERIODICALS

Biederman, Joseph A. "Is There a Childhood Form of Bipolar
Disorder?” Harvard Mental Health Letter. 13, no. 9
(March 1997): 8.

Bowden, Charles L. “Choosing the Appropriate Therapy for
Bipolar Disorder.” Medscape Mental Health. 2, no. 8
(1997). http://www.medscape.com.

Bowden, Charles L. “Update on Bipolar Disorder: Epidemiolo-
gy, Etiology, Diagnosis, and Prognosis.” Medscape Men-
tal Health. 2, no. 6 (1997). http://www.medscape.com.
"Family-focused Therapy May Reduce Relapse Rate." Health
& Medicine Week (September 29, 2003): 70.

Francis, A., J.P Docherty, and D.A. Kahn. "The Expert Con-
sensus Guideline Series: Treatment of Bipolar Disorder.”
Journal of Clinical Psychiatry. 57, supplement 12A (No-
vember 1996): 1-89.

Sherman, Carl. “Progress in Bipolar Genetics slow, but promis-
ing.” Clinical Psychiatry News. 29, no. 12 (December
2001): 4.

Sherman, Carl. “Impulsivity a Key Characteristic of Bipolar
Disorder.” Clinical Psychiatry News. 29, no. 1 1 (Novem-
ber 2001): 35.

231

Bipolar disorder

Bites and stings

KEY TERMS

Affective disorder — An emotional disorder involv-
ing abnormal highs and/or lows in mood. Now
termed mood disorder.

Anticonvulsant medication — A drug used to pre-
vent convulsions or seizures; often prescribed in
the treatment of epilepsy. Several anticonvulsant
medications have been found effective in the
treatment of bipolar disorder.

Antipsychotic medication — A drug used to treat
psychotic symptoms, such as delusions or halluci-
nations, in which patients are unable to distin-
guish fantasy from reality.

Benzodiazpines — A group of tranquilizers having
sedative, hypnotic, antianxiety, amnestic, anticon-
vulsant, and muscle relaxant effects.

DSM-IV — Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition (DSM-IV). This
reference book, published by the American Psy-
chiatric Association, is the diagnostic standard for
most mental health professionals in the United
States.

ECT — Electroconvulsive therapy sometimes is
used to treat depression or mania when pharma-
ceutical treatment fails.

Hypomania — A milder form of mania that is char-
acteristic of bipolar II disorder.

Mania — An elevated or euphoric mood or irritable
state that is characteristic of bipolar I disorder.

Mixed mania/mixed state — A mental state in
which symptoms of both depression and mania
occur simultaneously.

Neurotransmitter — A chemical in the brain that
transmits messages between neurons, or nerve
cells. Changes in the levels of certain neurotrans-
mitters, such as serotonin, norepinephrine, and
dopamine, are thought to be related to bipolar
disorder.

Psychomotor retardation — Slowed mental and
physical processes characteristic of a bipolar de-
pressive episode.

“Schizophrenia and Bipolar Disorder Could Have Similar Ge-
netic Causes.” Genomics & Genetics Weekly (September
26, 2003): 85.

Spete, Heidi. “Rhythm Therapy Can Stabilize Bipolar Disorder
Patients.” Clinical Psychiatry News. (July 2003): 55.

232

ORGANIZATIONS

American Psychiatric Association (APA). Office of Public Af-
fairs. 1400 K Street NW, Washington. DC 20005. (202)
682-6119. http://www.psych.org/.

National Alliance for the Mentally 111 (NAMI). 200 North
Glebe Road, Suite 1015, Arlington, VA 22203-3754. (800)
950-6264. http://www.nami.org.

National Depressive and Manic-Depressive Association
(NDMDA). 730 N. Franklin St., Suite 501, Chicago, IL
60610. (800) 826-3632. http://www.ndmda.org.

National Institute of Mental Health (NIMH). 5600 Fishers
Lane, Rm. 7C-02, Bethesda, MD 20857. (301) 443-4513.
http://www.nimh.nih.gov/.

Paula Ford-Martin
Teresa G. Odle

Birth see Childbirth

Bites and stings

Definition

A bite is an injury caused by an animal, such as a
mammal or insect, that breaks the skin. A sting is a punc-
ture wound made by insects or marine animals. There is
often a danger of infection from toxins or venom with
bites and stings.

Description

In the United States, dogs surpass all other mammals
in the number of bites inflicted on humans. Children face
a greater risk than adults, and children under 10 years old
are more liable than anyone to suffer serious bites to the
face, neck, and head. Cat bites are far less common than
dog bites, but they carry a higher risk of infection. Bites
from wild animals should be of especial concern due to
the risk of rabies. More than 70,000 human-to-human
bites a year are reported in the United States. Human
bites are more infectious than those of any other animal.

The most common invertebrates responsible for
bites and stings include lice, bedbugs, fleas, mosquitoes,
black flies, fire ants, chiggers, ticks, centipedes, scorpi-
ons, spiders, bees, and wasps. Black widows and brown
recluse spiders are the two most common poisonous spi-
ders in the United States. The bites of most other spiders
in North America cause only minor reactions. Ticks at-
tach themselves to the skin and feed on the blood of ani-
mals. Most are relatively harmless, but some carry dis-
eases such as Rocky Mountain spotted fever and Lyme